RT Journal Article
T1 Cervical pessary placement for prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial.
A1 Nicolaides, Kypros H
A1 Syngelaki, Argyro
A1 Poon, Liona C
A1 de Paco Matallana, Catalina
A1 Plasencia, Walter
A1 Molina, Francisca S
A1 Picciarelli, Gemma
A1 Tul, Natasa
A1 Celik, Ebru
A1 Lau, Tze Kin
A1 Conturso, Roberto
K1 Arabin pessary
K1 cervical length
K1 neonatal morbidity
K1 prematurity
K1 preterm birth
K1 sonographic short cervix
K1 twins
AB Preterm birth is the leading cause of neonatal death and handicap in survivors. Although twins are found in 1.5% of pregnancies they account for about 25% of preterm births. Randomized controlled trials in singleton pregnancies reported that the prophylactic use of progestogens, cervical cerclage and cervical pessary reduce significantly the rate of early preterm birth. In twin pregnancies, progestogens and cervical cerclage have been shown to be ineffective in reducing preterm birth. 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. This was a multicenter, randomized controlled trial in unselected twin pregnancies of cervical pessary placement from 20(+0)-24(+6) weeks' gestation until elective removal or delivery vs. expectant management. Primary outcome was spontaneous birth  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  In women with twin pregnancy, routine treatment with cervical pessary does not reduce the rate of spontaneous early preterm birth.
YR 2015
FD 2015-08-28
LK http://hdl.handle.net/10668/10149
UL http://hdl.handle.net/10668/10149
LA en
DS RISalud
RD Apr 9, 2025