Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Comparing the Efficacy of Pessary As an Adjunctive Therapy After Cerclage, and Cerclage Alone in Prevention of Spontaneous Preterm Birth: A Randomized Controlled Trial Publisher



Moshfeghi M1 ; Arjmandifar M2 ; Mohammadi M3 ; Eftekhari M4 ; Keikhaie KR5
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine ACECR, Tehran, Iran
  2. 2. Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Department of Obstetrics and Gynecology, Zabol University of Medical Sciences, Zabol, Iran

Source: Journal of Obstetrics# Gynecology and Cancer Research Published:2022


Abstract

Background & Objective: The aim of this study was to evaluate the effectiveness of adjunctive pessary therapy after cerclage in increasing the gestational age (GA) to 37 weeks in women with cervical insufficiency (CI). Materials & Methods: This randomized controlled trial (RCT) was conducted at the infertility department of Royan Institute, Tehran, Iran. A total of 170 singleton pregnant women aged 18-42 years old, diagnosed with CI by GA 14-24weeks, who had intact membrane with no signs of intrauterine infection, vaginal bleeding, or uterine contraction, were enrolled. Patients were randomized 1:1 to receive either cervical cerclage or pessary after cerclage. The primary outcome was spontaneous preterm birth (SPB) (<37weeks). The secondary outcomes were GA at the time of delivery, SPB (less than 34, 32 & 28 weeks), delivery method, neonatal outcomes, maternal adverse events, and maternal satisfaction with the intervention. Results: The incidence of SPB (<37, 34, 32 & 28weeks), method of delivery, GA at time of delivery, and neonatal outcomes were not significantly different between the two groups. The incidence of vaginal bleeding (P=0.007) and pelvic pain (P=0.03) significantly was less in the intervention group. The mean score of satisfaction in the intervention group was significantly higher than the control group (P=0.01). Conclusion: The placement of an adjunctive pessary for pregnant women with singleton pregnancy and CI, did not result in a lower rate of SPB (<37weeks) compared to cerclage alone. However, pregnancy complications after the intervention until delivery were less in these women, while the level of satisfaction was higher. © 2022, Farname Inc. All rights reserved.
Related Docs
1. Combined Treatment With Cervical Pessary and Vaginal Progesterone for the Prevention of Preterm Birth: A Randomized Clinical Trial, Journal of Obstetrics and Gynaecology Research (2016)
2. Comparison of Risk of Preterm Labor Between Vaginal Progesterone And17-Alpha-Hydroxy-Progesterone Caproate in Women With Threatened Abortion: A Randomized Clinical Trial, International Journal of Fertility and Sterility (2016)
3. 17-Alpha-Hydroxyprogesterone Caproate Versus Vaginal Progesterone Suppository for the Prevention of Preterm Birth in Women With a Sonographically Short Cervix: A Randomized Controlled Trial, Journal of Obstetrics and Gynaecology Research (2017)
4. Maternal and Fetal Doppler Blood Flow Velocimetry Changes in the Management of Asymptomatic Preterm Labor With Vaginal Progesterone Tablet, Acta Medica Iranica (2018)
5. Reproductive Outcomes Among Female Health Care Workers, BMC Women's Health (2024)
Experts (# of related papers)
View all Related Experts
Reihaneh Pirjani (3)
Nazanin Izadi (1)