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Use of the Pessary in the Prevention of Preterm Delivery

Thayane Delazari Corrêa1, Ester Gomes Amorim1, Jade Aimée Guimarães Tomazelli1

  • 1Departament of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Revista Brasileira De Ginecologia E Obstetricia : Revista Da Federacao Brasileira Das Sociedades De Ginecologia E Obstetricia
|February 5, 2019
PubMed

Insights

A cervical pessary did not show effectiveness in preventing preterm birth. Pooled data from randomized trials indicate no significant reduction in births before 37 or 34 weeks gestation.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Clinical Trial Analysis

Background:

  • Spontaneous preterm birth (<37 weeks) is a major cause of perinatal mortality and morbidity.
  • Identifying effective prevention strategies for preterm birth is crucial.
  • The efficacy of cervical pessaries for preventing prematurity requires further investigation.

Purpose of the Study:

  • To analyze published studies on the use of cervical pessaries for preterm birth prevention.
  • To compare the efficacy of cervical pessaries with other methods for preventing premature delivery.

Main Methods:

  • Systematic review and meta-analysis of randomized clinical trials (2010-2018).
  • Exclusion of studies involving multiple gestations.
  • Analysis of outcomes related to births <37 weeks and <34 weeks gestation.

Main Results:

  • Meta-analysis revealed no statistically significant difference in reducing births <37 weeks (OR: 0.63; 95% CI: 0.38-1.06).
  • No significant reduction was observed for births <34 weeks (OR: 0.74; 95% CI: 0.35-1.57).
  • Heterogeneity among studies complicated direct comparisons of efficacy.

Conclusions:

  • Current pooled data suggest a lack of efficacy for cervical pessaries in preventing preterm birth.
  • Further research may be needed to clarify the role of pessaries, considering study heterogeneity.
Abstract

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