The Mechanical “Fix” of the Pessary May Not Solve the Problem of Preterm Birth

As preterm birth is the leading cause of infant morbidity and mortality, interest is focused on interventions to lower its incidence. Although cervical cerclage has not proven effective for women at excess risk for preterm delivery due to a short cervix, placement of a silicone ring pessary has held early promise for such women; however, trial results have been inconsistent. In an international study, U.K. investigators sought additional evidence that pessary placement can reduce risk for early preterm birth.

A total of 935 women with singleton pregnancies at 20 to 25 weeks' gestation and cervical lengths <25 mm were randomized to pessary placement or expectant management (control group). All women with cervical lengths <15 mm were additiona…