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Preterm birth has proven elusive to prevent, with few clearly efficacious evidence-based interventions. Use of a cervical pessary in the setting of short cervix has been studied in several trials with mixed results; and a meta-analysis showing no benefit effectively nullified this inexpensive intervention. Now, Italian investigators have conducted another randomized trial of pessary use versus nonuse (control) in 300 asymptomatic women with cervical lengths <25 mm and no prior preterm births. All participants with cervical lengths <20 mm received vaginal progesterone regardless of group assignment.
Mean cervical length at study entry was 12 mm. Compared with the women in the control group, those who received pessaries were less likely to exp…