Cervical pessary for the prevention of preterm birth: is it of any use?

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Medical Devices

Background:

• Preterm birth (PTB) is a significant cause of perinatal morbidity and mortality.
• Transvaginal sonography (TVS) screening has influenced secondary PTB prevention strategies based on cervical length (CL).
• The cervical pessary, a mechanical silicone device, is gaining interest for PTB prevention, but its efficacy remains debated.

Purpose of the Study:

• To review current evidence on the efficacy of cervical pessary for preventing PTB.
• To explore correct pessary placement, mechanism of action, exclusion criteria, and reasons for removal.
• To synthesize data on the safety and effectiveness of cervical pessaries in obstetric care.

Main Methods:

• Systematic review of recent scientific literature.
• Analysis of studies evaluating cervical pessary use for PTB prevention.
• Assessment of safety data, including side effects and tolerance.

Main Results:

• Cervical pessary placement is generally well-tolerated with no severe reported side effects.
• Evidence suggests potential efficacy in preventing PTB for both singleton and multiple gestations.
• Published data on cervical pessary efficacy show conflicting results, necessitating further investigation.

Conclusions:

• The cervical pessary appears to be a safe intervention for secondary PTB prevention.
• While promising, conclusive evidence supporting the widespread use of cervical pessaries for PTB prevention is still lacking.
• Further high-quality studies are required to establish definitive efficacy and optimal application protocols.