Cervical pessary to reduce preterm birth34 weeks of gestation after an episode of preterm labor and a short cervix: a randomized controlled trial
| Autor: | Laia Pratcorona, Maria Goya, Carme Merced, Carlota Rodó, Elisa Llurba, Teresa Higueras, Luis Cabero, Elena Carreras, Silvia Arévalo, Mayte Avilés, Inés Calero, Manel Casellas, Marina Folch, Andrea Gascón, Manel Mendoza, Mª Angeles Sanchez, Anna Suy |
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| Rok vydání: | 2018 |
| Předmět: |
Cervical pessary
Pessary Adult medicine.medical_specialty Fetal Membranes Premature Rupture Preterm labor Tocolysis law.invention Birth rate 03 medical and health sciences Young Adult 0302 clinical medicine Threatened Preterm Labor Obstetric Labor Premature Randomized controlled trial law Enterocolitis Necrotizing Pregnancy Intensive Care Units Neonatal Infant Mortality Medicine Humans 030212 general & internal medicine Cerebral Intraventricular Hemorrhage Respiratory Distress Syndrome Newborn 030219 obstetrics & reproductive medicine business.industry Obstetrics Infant Newborn Obstetrics and Gynecology Infant Pessaries Short cervix Cervical Length Measurement Infant Extremely Premature Gestation Premature Birth Female business Infant Premature |
| Zdroj: | American journal of obstetrics and gynecology. 219(1) |
| ISSN: | 1097-6868 |
| Popis: | To date, no intervention has proved effective in reducing the spontaneous preterm birth rate in singleton pregnancies following an episode of threatened preterm labor and short cervix remaining.This study was designed to ascertain whether cervical pessaries could be useful in preventing spontaneous preterm birth in women with singleton pregnancies and a short cervix after a threatened preterm labor episode.This open randomized controlled trial was conducted in 357 pregnant women (between 24No significant differences between the pessary and routine management groups were observed in the spontaneous preterm birth rate34 weeks (19/177 [10.7%] in the pessary group vs 24/175 [13.7%] in the control group; relative risk, 0.78; 95% confidence interval, 0.45-1.38). Spontaneous preterm birth37 weeks occurred less frequently in the pessary group (26/175 [14.7%] vs 44/175 [25.1%]; relative risk, 0.58; 95% confidence interval, 0.38-0.90; P = .01). Preterm premature rupture of membranes rate was significantly lower in pessary carriers (4/177 [2.3%] vs 14/175 [8.0%]; relative risk, 0.28; 95% confidence interval, 0.09-0.84; P = .01). The pessary group less frequently required readmission for new threatened preterm labor episodes (8/177 [4.5%] vs 35/175 [20.0%]; relative risk, 0.23; 95% confidence interval, 0.11-0.47; P.0001). No serious adverse maternal events occurred; neonatal morbidity and mortality were similar in both groups.Pessary use did not significantly lower the spontaneous preterm birth rate34 weeks in women with a short cervix remaining after a threatened preterm labor episode but did significantly reduce the spontaneous preterm birth rate37 weeks, threatened preterm labor recurrence, and the preterm premature rupture of membranes rate. |
| Databáze: | OpenAIRE |
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