A clinical trial supported by the National Institute for Health Research (NIHR) has found that a new treatment for pregnant women at high risk of preterm birth can prevent both very preterm birth and death of babies.
The trial – called The Multicentre Randomised Controlled Trial of Transabdominal Versus Transvaginal Cervical Cerclage (MAVRIC) study - found that pregnant women who received an abdominal stitch instead of the traditional vaginal stitch were less likely to give birth before 32 weeks of pregnancy, as well as being more likely to give birth to a baby that survives.
The 10-year, UK-wide randomised controlled trial evaluated over 100 women and found that rates of preterm birth at less than 32 weeks were as much as 30% lower in women who received abdominal stitching than in those who received vaginal stitching.
The study was the first randomised trial to test abdominal stitch in this group of women, and Professor Andrew Shennan, clinical director of Tommy’s Preterm Surveillance Clinic at Guy’s and St Thomas’, commented that the clinic is “delighted to show that women who lose multiple babies, even after failed stitches will usually have successful pregnancies with an abdominal stitch.”
The NIHR reminded that an abdominal stitch leads to the need for a c-section during birth, because the procedure means that women are unable to have a natural vaginal birth. Therefore, it is important that the treatment is used in high risk women who have had a previous vaginal stitch that has failed.
Stitches are used when women have had premature labour in a previous pregnancy, a miscarriage, surgery, or trauma to the cervix and may be at risk of a condition called cervical insufficiency, where the cervix widens and shortens during pregnancy.