Braided Polyester Sutures with Different Manufacturing Characteristics in Cervical Cerclage: A Pilot Study Comparing...

Background and Objectives: The effect of suture material on clinical outcomes in cervical cerclage remains debated. This pilot study compared two braided polyester suture materials with different manufacturing characteristics (Mersilene^® and Uniester^®) in terms of obstetric outcomes and operative characteristics. Methods: Twenty-two pregnant women who underwent McDonald cerclage at a single center between January 2024 and December 2025 were retrospectively analyzed. Cases were divided into Mersilene^® (n = 11) and Uniester^® (n = 11) groups and compared regarding demographic characteristics, maternal complications, gestational age at delivery, neonatal outcomes, and operative time. Risk factors for preterm birth were assessed using multivariable logistic and linear regression analyses. Results: No significant differences were observed between groups in demographic, maternal, or neonatal outcomes. Median gestational age at delivery was 34.8 vs. 35.1 weeks (p = 1.00). Operative time was shorter in the Uniester^® group, although the difference did not reach statistical significance (21.1 vs. 24.4 min; mean difference 3.3 min, 95% CI: -1.5 to 8.1; p = 0.17). Multivariable analysis identified multiple pregnancy as the only independent predictor of preterm birth (OR = 12.5, 95% CI: 1.292-120.96, p = 0.029). Conclusions: The findings of this pilot study indicate that no statistically significant differences in obstetric or neonatal outcomes were observed between the two suture materials; given the limited sample size, this should not be interpreted as evidence of equivalence. The primary determinants of pregnancy prognosis were biological parameters, primarily multiple pregnancy, rather than suture material; preoperative cervical length showed only a non-significant trend toward association. The reportedly favorable handling characteristics and the non-significantly shorter operative time associated with Uniester^® may suggest a potential, though unconfirmed, technical advantage in terms of operative efficiency, particularly in time-sensitive or high-risk procedural contexts. Larger prospective multicenter studies are warranted to confirm these findings and to further evaluate whether differences in suture structure translate into clinically meaningful benefits.