Abstract | BACKGROUND: OBJECTIVE: The objective of this study was to test the hypothesis that the insertion of a cervical pessary in twin pregnancies would reduce the rate of spontaneous early preterm birth. STUDY DESIGN: RESULTS: A total of 1,180 (56.0%) of the 2,107 eligible women agreed to take part in the trial; 590 received cervical pessary and 590 had expectant management. Two of the former and one of the latter were lost to follow up. There were no significant differences between the pessary and control groups in rates of spontaneous birth <34 weeks (13.6% vs. 12.9%; relative risk 1.054, 95% confidence interval [CI] 0.787-1.413; p=0.722), perinatal death (2.5% vs. 2.7%; relative risk 0.908, 95% CI 0.553-1.491; p=0.702), adverse neonatal outcome (10.0 vs. 9.2%; relative risk 1.094, 95% CI 0.851-1.407; p=0.524) or neonatal therapy (17.9% vs. 17.2%; relative risk 1.040, 95% CI 0.871-1.242; p=0.701). A post hoc subgroup analysis of 214 women with short cervix (≤25 mm) showed no benefit from the insertion of a cervical pessary. CONCLUSION: In women with twin pregnancy, routine treatment with cervical pessary does not reduce the rate of spontaneous early preterm birth.
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Authors | Kypros H Nicolaides, Argyro Syngelaki, Liona C Poon, Catalina de Paco Matallana, Walter Plasencia, Francisca S Molina, Gemma Picciarelli, Natasa Tul, Ebru Celik, Tze Kin Lau, Roberto Conturso |
Journal | American journal of obstetrics and gynecology
(Am J Obstet Gynecol)
Vol. 214
Issue 1
Pg. 3.e1-9
(Jan 2016)
ISSN: 1097-6868 [Electronic] United States |
PMID | 26321037
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2016 Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Cervix Uteri
(diagnostic imaging)
- Enterocolitis, Necrotizing
(prevention & control)
- Female
- Humans
- Infant, Newborn
- Intention to Treat Analysis
- Intracranial Hemorrhages
(prevention & control)
- Perinatal Death
(prevention & control)
- Pessaries
- Pregnancy
- Pregnancy, Twin
- Premature Birth
(prevention & control)
- Respiratory Distress Syndrome, Newborn
(prevention & control)
- Retinopathy of Prematurity
(prevention & control)
- Ultrasonography
- Watchful Waiting
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