Cervical pessary placement unrelated to preterm births, other complications
Placement of cervical pessary in women with short cervices and singleton pregnancies does not lower the risk of having preterm births, according to the results of a meta-analysis.
Embase, Pubmed and the Cochrane Central Register of Controlled Trials were the databases accessed for the study. Those related to pessary, premature birth or premature labor were considered for eligibility.
Studies investigating pessary placement in women with mid-trimester bleeding, regular contractions or premature membrane rupture were excluded. The primary outcome was preterm birth before 34 weeks. Preterm births before 30 and 28 weeks and respiratory distress syndrome, among other complications, were secondary outcomes.
After applying the exclusion and inclusion criteria, only three trials corresponding to 1,412 women were found eligible for the meta-analysis. From these, it was found that cervical pessary did not reduce the risk of spontaneous preterm births before 34 weeks (risk ratio [RR], 0.71; 95 percent CI, 0.21 to 2.43; p=0.59).
Furthermore, the meta-analysis revealed that employing cervical pessary placement also did not influence the risk of spontaneous preterm births before 30 and 28 weeks.
Similarly, neonatal sepsis, respiratory distress syndrome, foetal death, necrotising entercolitis, intraventricular hemorrhage, perinatal death, retinopathy of prematurity and neonatal death, along with other complications, were also not associated with cervical pessary placements.
The findings show that there is no association between placement of cervical pessary and the risk of spontaneous preterm births or other complications in women with singleton pregnancies or short cervices. However, large-scale randomized controlled trials are necessary in order to make better conclusions.