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Cervical pessary for preventing preterm birth: a meta-analysis
Zhen Jin1,2, Liqin Chen3, Dongyan Qiao4
1a Department of Gynecology , Central Hospital , Nanjing , China.
Summary
Cervical pessary use may prolong pregnancy and reduce the need for tocolysis and corticosteroids in some cases. Further research is ongoing to confirm these findings on preventing preterm birth.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Preterm birth remains a significant challenge in obstetrics.
- Cervical pessaries are devices used to support the cervix.
- Their efficacy in preventing preterm birth requires further evaluation.
Purpose of the Study:
- To assess the effectiveness of cervical pessary in preventing preterm birth.
- To analyze the impact of cervical pessary on pregnancy and maternal outcomes.
- To provide a clinical evidence base for the use of cervical pessaries in preterm birth prevention.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Web of Science, CNKI, WanFang Data).
- Eligible studies were reviewed by two independent researchers.
- Statistical analysis was performed using Stata 12.0.
Main Results:
- Cervical pessary use showed a trend towards reducing preterm birth rates, though not always statistically significant across all gestational age subgroups.
- A significant decrease was observed in the utilization of tocolytic agents (21%) and corticosteroids (18%) in the pessary group.
- While not statistically significant for all outcomes, the risk of neonatal sepsis was reduced by 55% with pessary use.
Conclusions:
- Cervical pessary may offer benefits in prolonging pregnancy compared to expectant management.
- It can lead to a reduced need for tocolysis and corticosteroid administration.
- Ongoing registered trials are expected to provide more definitive data on its efficacy.
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