Cervical Pessary After Arrested Preterm Labor: A Randomized Controlled Trial

Area of Science:

• Maternal-fetal medicine
• Obstetrics
• Perinatology

Background:

• Preterm birth remains a leading cause of neonatal morbidity and mortality.
• Identifying effective interventions for women at high risk of preterm birth is crucial.
• Women experiencing threatened preterm labor require strategies to prolong gestation.

Purpose of the Study:

• To evaluate the efficacy of a cervical pessary in preventing preterm birth.
• To assess the impact of cervical pessary on adverse neonatal outcomes.
• To determine the effectiveness of pessary use in high-risk pregnancies post-threatened preterm labor.

Main Methods:

• A multicenter, open-label, randomized controlled trial compared cervical pessary to no intervention.
• Eligible participants were women (24-34 weeks gestation) with high-risk factors for preterm birth.
• The primary outcome was delivery before 37 weeks gestation; secondary outcomes included adverse neonatal events.

Main Results:

• The study was stopped early for futility after enrolling 130 women.
• Preterm birth before 37 weeks occurred in 48% of the pessary group versus 39% in the control group.
• No significant difference was observed in composite adverse perinatal outcomes between groups.

Conclusions:

• Cervical pessary treatment was found to be ineffective in reducing preterm birth rates.
• The intervention did not improve neonatal outcomes in this high-risk population.
• Further research may be needed to explore alternative strategies for preventing preterm birth in similar cases.