Cervical Pessary Cuts Preterm Birth in Women With Short Cervix
TUESDAY, Dec. 19, 2017 -- Cervical pessary is associated with a lower rate of spontaneous preterm birth at less than 34 weeks of gestation among women without prior spontaneous preterm birth who had asymptomatic singleton pregnancies and short transvaginal cervical length, according to a study published in the Dec. 19 issue of the Journal of the American Medical Association.
Gabriele Saccone, M.D., from the University of Naples Federico II in Italy, and colleagues randomized asymptomatic women with singleton pregnancies with no prior spontaneous preterm birth but with short cervical length to receive cervical pessary or no pessary (150 patients in each group). The pessary was removed between 37 weeks 0 days and 37 weeks 6 days of gestation, unless clinically indicated for earlier removal; the control group received standard care. Spontaneous preterm birth at less than 34 weeks of gestation was the primary end point.
The researchers found that significantly fewer women in the pessary group versus the control group had the primary end point (7.3 versus 15.3 percent; relative risk, 0.48). The pessary group had an elevated rate of increased or new vaginal discharge during follow-up (86.7 versus 46.0 percent; relative risk, 1.88).
"Among women without prior spontaneous preterm birth who had asymptomatic singleton pregnancies and short transvaginal cervical length, use of a cervical pessary, compared with no pessary use, resulted in a lower rate of spontaneous preterm birth at less than 34 weeks of gestation," the authors write. "The results of this single-center, nonblinded study among selected pregnant women require confirmation in multicenter clinical trials."
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Posted: December 2017