Cervical pessary for preventing preterm birth.

19:33 EDT 29th August 2015 | BioPortfolio

Summary of "Cervical pessary for preventing preterm birth."


BACKGROUND:
Preterm delivery is a major health problem and contributes to more than 50% of the overall perinatal mortality. Cervical incompetence is one of the common causes of preterm birth to which different management strategies have been tried including cervical cerclage. Cervical cerclage is an invasive technique that needs anaesthesia and may be associated with complications. Moreover, there is still a matter of controversy regarding the efficacy and the group of patients which could benefit from this operation. Cervical pessary has been tried as a simple, non-invasive alternative that might replace the above invasive cervical stitch operation.
OBJECTIVES:
To evaluate the efficacy of cervical pessary for prevention of preterm birth in women with cervical incompetence. SEARCH
STRATEGY:
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (May 2010), Current Controlled Trials and the Australian New Zealand Clinical Trials Registry (May 2010). SELECTION
CRITERIA:
We selected all published and unpublished randomised clinical trials comparing the use of cervical pessary with cervical cerclage or expectant management for prevention of preterm birth. We did not include quasi-randomised trials, cluster-randomised and crossover trials. DATA COLLECTION AND
ANALYSIS:
Two review authors independently assessed trials for inclusion. MAIN
RESULTS:
The search identified two trials which we excluded. Three additional trials are ongoing. This review contains no included studies. AUTHORS'
CONCLUSIONS:
The review did not identify any well-designed randomised clinical trial in order to confirm or refute the benefit of cervical pessary. However, there is evidence from non-randomised trials that showed some benefit of cervical pessary in preventing preterm birth. We are waiting for the results of three ongoing randomised controlled trials, assessing the role of cervical pessary in women with short cervix. There is a need for further well-designed randomised controlled trials.

Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt, 71511.

Journal Details

This article was published in the following journal.

Name: Cochrane database of systematic reviews (Online)
ISSN: 1469-493X
Pages: CD007873

Links

PubMed Articles [4674 Associated PubMed Articles listed on BioPortfolio]

Spontaneous Preterm Birth in Multiples.

The number of multiple gestations has increased over the last several decades and preterm birth is one of the leading causes of perinatal morbidity and mortality for these pregnancies. While screening...

E. Nohuz in reply to the article by H. Collinot et E. Azria entitled "Cervical pessary for preventing preterm birth". Gynecol Obstet Fertil 2013;41:260-1.

Cervical sonoelastography for improving prediction of preterm birth compared with cervical length measurement and fetal fibronectin test.

Abstract Aim: Accurate prediction of the risk of spontaneous preterm birth is crucial for the clinical management of patients with preterm labor. The aim of the study was to investigate whether cervic...

The association between cervical dysplasia, a short cervix, and preterm birth.

To determine whether cervical dysplasia in the absence of an excisional procedure is associated with an increased risk of preterm birth and whether that risk is independent of the presence of a short ...

Management of preterm labor on cervical-uterine incompetence using a pessary cerclage obstetrical.

Clinical Trials [2406 Associated Clinical Trials listed on BioPortfolio]

Prevention of Preterm Birth Using Cervical Pessary in Pregnant Women With Short Cervix

Placement of a vaginal pessary reduces significantly the rate of spontaneous preterm birth in pregnant women with short cervical length at 18-22 weeks scan.

Comparison Between Natural Progesterone and Vaginal Pessary for the Prevention of Spontaneous Preterm Birth

The aim of this study is to compare the effectiveness between the cervical pessary and the natural progesterone in reduction of preterm birth rates in pregnant women with a uterine cervica...

Cervical Pessary vs Vaginal Progesterone in Preventing Preterm Birth Among Women Presenting With Short Cervix: An Open-label Randomized Controlled Trial

The purpose of this randomized control trial is to determine whether cervical pessary plus vaginal progesterone is superior to vaginal progesterone alone in decreasing preterm delivery rat...

Prevention of Preterm Birth in Singletons Using Pessary After Resolutive Threatened Preterm Labor

In France, threatened preterm labour concerns 6.5% of pregnancies and is associated with a premature birth in 25.4% of cases. After 48 hours effective tocolysis, patients do not receive a...

Randomized Study of Pessary Versus Standard Management in Women With Increased Chance of Premature Birth

The aim of the study is to determine the effect of cerclage pessary on the incidence of spontaneous delivery between randomization (at 20-24+6 weeks) and 33+6 weeks in asymptomatic women w...

Medical and Biotech [MESH] Definitions

A parameter usually used in PRENATAL ULTRASONOGRAPHY to measure the length of the uterine neck (CERVIX UTERI). Cervical length or its shortening is used to identify and prevent early cervical opening and PRETERM BIRTH.

A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm.

Drugs that prevent preterm labor and immature birth by suppressing uterine contractions (TOCOLYSIS). Agents used to delay premature uterine activity include magnesium sulfate, beta-mimetics, oxytocin antagonists, calcium channel inhibitors, and adrenergic beta-receptor agonists. The use of intravenous alcohol as a tocolytic is now obsolete.

Postnatal deaths from BIRTH to 365 days after birth in a given population. Postneonatal mortality represents deaths between 28 days and 365 days after birth (as defined by National Center for Health Statistics). Neonatal mortality represents deaths from birth to 27 days after birth.

Official certifications by a physician recording the individual's birth date, place of birth, parentage and other required identifying data which are filed with the local registrar of vital statistics.


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