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Although preterm birth is common and carries high economic and health-related costs, effective strategies to lower its incidence have been few and far between. The use of cervical pessaries by at-risk women has been advocated despite the lack of Level I evidence to support the practice. Spanish investigators undertook an open-label trial to assess the efficacy of cervical pessaries for preventing preterm birth among women with second-trimester cervical length ≤25 mm. A total of 385 eligible women were randomized to pessary insertion or expectant management.
Women in the pessary group were less likely to deliver before 34 weeks (6% vs. 27%, P<0.0001) or before 28 weeks (2% vs. 8%, P<0.01). Infants born to women using pessaries were significan…