Cervical pessary for preventing preterm birth in twin pregnancies with short cervical length: a systematic review and meta-analysis.

Authors

• Gabriele Saccone
• Andrea Ciardulli
• Serena Xodo
• Lorraine Dugoff
• Jack Ludmir
• Francesco D'Antonio
• Simona Boito
• Elena Olearo
• Carmela Votino
• Giuseppe Maria Maruotti
• Giuseppe Rizzo
• Pasquale Martinelli
• Vincenzo Berghella

Publication/Presentation Date

12-1-2017

Abstract

OBJECTIVE: To evaluate the effectiveness of cervical pessary for preventing spontaneous preterm birth (SPTB) in twin pregnancies with an asymptomatic transvaginal ultrasound cervical length (TVU CL) in the second trimester.

METHODS: We performed a meta-analysis including all randomized clinical trials (RCTs) comparing the use of cervical pessary (i.e. intervention group) with expectant management (i.e. control group). The primary outcome was incidence of SPTB < 34 weeks.

RESULTS: Three trials, including 481 twin pregnancies with short cervix, were analyzed. Two RCTs defined short cervix as TVU CL ≤25 mm and one as TVU CL ≤38 mm. Pessary was not associated with prevention of SPTB, and the mean gestational age at delivery and the mean latency were similar in the pessary group compared to the control group. Moreover, no benefits were noticed in neonatal outcomes.

CONCLUSIONS: Use of the Arabin pessary in twin pregnancies with short TVU CL at 16-24 weeks does not prevent SPTB or improve perinatal outcome.

Volume

30

Issue

24

First Page

2918

Last Page

2925

ISSN

1476-4954

Published In/Presented At

Saccone, G., Ciardulli, A., Xodo, S., Dugoff, L., Ludmir, J., D'Antonio, F., Boito, S., Olearo, E., Votino, C., Maruotti, G. M., Rizzo, G., Martinelli, P., & Berghella, V. (2017). Cervical pessary for preventing preterm birth in twin pregnancies with short cervical length: a systematic review and meta-analysis. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 30(24), 2918–2925. https://doi.org/10.1080/14767058.2016.1268595

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

27915496

Department(s)

Administration and Leadership

Document Type

Article