Cervical pessary significantly reduces risk of preterm birth

A randomized trial shows that use of a cervical pessary lowers preterm birth in appropriately selected women

For women with a short cervix, use of a cervical pessary significantly reduces the risk of spontaneous delivery before 34 weeks, according to a randomized trial published online in The Lancet.

To investigate whether insertion of a cervical pessary in women with a short cervix reduces the rate of early preterm delivery, Maria Goya, MD, from the Universitat Autonoma de Barcelona in Spain, and colleagues conducted a randomized controlled trial of 385 pregnant women. Participants, who were identified at gestational weeks 20 to 23 as having a cervical length of 25 mm or less, were randomized to cervical pessary (192 women) or expectant management (193 women); 190 women in each group were analyzed.

The researchers found that, compared with the expectant management group, spontaneous delivery before 34 weeks was significantly less frequent in the pessary group (6% versus 27%; odds ratio, 0.18). There were no serious adverse effects reported with use of the cervical pessary.

“The cervical pessary is an affordable, safe, and reliable alternative for prevention of preterm birth in a population of appropriately selected at-risk pregnant women who have been screened for cervical length assessment at the midtrimester scan,” the authors write.

The abstract is available at: http://bit.ly/HyPaXD

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