Pessary for Prevention of Preterm Birth and Perinatal Mortality in Pregnancies with a Short Cervix: Systematic Review and Meta-Analysis of Randomized Controlled Trials
<b>Objective:</b> This systematic review and meta-analysis aimed to evaluate the efficacy of cervical pessaries in preventing perinatal mortality and extreme preterm birth in pregnancies characterized by a short cervix. <b>Methods</b>: The analysis included data from nine ran...
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MDPI AG
2025-06-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/15/12/1466 |
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| author | Henrique Graf Provinciatto Edward Araujo Júnior Gustavo Yano Callado Alan Roberto Hatanaka Roberto Angelo Fernandes Santos Evelyn Traina Gabriela Ubeda Santucci França Luiza Graça Coutinho Alan Lebrão de Amorim Lucas Almeida das Chagas Rosiane Mattar Marcelo Santucci França |
| author_facet | Henrique Graf Provinciatto Edward Araujo Júnior Gustavo Yano Callado Alan Roberto Hatanaka Roberto Angelo Fernandes Santos Evelyn Traina Gabriela Ubeda Santucci França Luiza Graça Coutinho Alan Lebrão de Amorim Lucas Almeida das Chagas Rosiane Mattar Marcelo Santucci França |
| author_sort | Henrique Graf Provinciatto |
| collection | DOAJ |
| description | <b>Objective:</b> This systematic review and meta-analysis aimed to evaluate the efficacy of cervical pessaries in preventing perinatal mortality and extreme preterm birth in pregnancies characterized by a short cervix. <b>Methods</b>: The analysis included data from nine randomized controlled trials (RCTs), incorporating a total of 3813 participants. These studies compared the use of cervical pessaries against standard care or other interventions in preventing preterm births in women with a short cervix, defined as less than 30 mm. The eligibility criteria for the trials included studies on asymptomatic pregnant women with a short cervix. The primary outcomes analyzed were perinatal mortality and the incidence of preterm birth before 28 weeks of gestation. <b>Results</b>: The results showed an imprecise effect estimate for perinatal mortality (OR = 0.93; 95% CI: 0.54 to 1.62). Similarly, the risk reduction for preterm birth before 28 weeks was also non-significant (OR = 0.76; 95% CI: 0.49 to 1.15). Substantial heterogeneity was observed among the studies (I<sup>2</sup> = 62%), suggesting variability in the study results, which could have been influenced by differences in the study design, population, and interventions. <b>Conclusions</b>: Although the results were statistically inconclusive and the estimates imprecise, the confidence intervals still span possible benefit and harm. Thus, while the current evidence does not support the routine use of cervical pessaries, it also does not indicate an increased risk of fetal or neonatal mortality. |
| format | Article |
| id | doaj-art-dff2812ec5794c1890b80a3aaabfbf34 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-dff2812ec5794c1890b80a3aaabfbf342025-08-20T03:26:52ZengMDPI AGDiagnostics2075-44182025-06-011512146610.3390/diagnostics15121466Pessary for Prevention of Preterm Birth and Perinatal Mortality in Pregnancies with a Short Cervix: Systematic Review and Meta-Analysis of Randomized Controlled TrialsHenrique Graf Provinciatto0Edward Araujo Júnior1Gustavo Yano Callado2Alan Roberto Hatanaka3Roberto Angelo Fernandes Santos4Evelyn Traina5Gabriela Ubeda Santucci França6Luiza Graça Coutinho7Alan Lebrão de Amorim8Lucas Almeida das Chagas9Rosiane Mattar10Marcelo Santucci França11Department of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilAlbert Einstein Israelite College of Health Sciences, Albert Einstein Israelite Hospital, Sao Paulo 05653-120, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, BrazilDepartment of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Sao Paulo 04023-062, Brazil<b>Objective:</b> This systematic review and meta-analysis aimed to evaluate the efficacy of cervical pessaries in preventing perinatal mortality and extreme preterm birth in pregnancies characterized by a short cervix. <b>Methods</b>: The analysis included data from nine randomized controlled trials (RCTs), incorporating a total of 3813 participants. These studies compared the use of cervical pessaries against standard care or other interventions in preventing preterm births in women with a short cervix, defined as less than 30 mm. The eligibility criteria for the trials included studies on asymptomatic pregnant women with a short cervix. The primary outcomes analyzed were perinatal mortality and the incidence of preterm birth before 28 weeks of gestation. <b>Results</b>: The results showed an imprecise effect estimate for perinatal mortality (OR = 0.93; 95% CI: 0.54 to 1.62). Similarly, the risk reduction for preterm birth before 28 weeks was also non-significant (OR = 0.76; 95% CI: 0.49 to 1.15). Substantial heterogeneity was observed among the studies (I<sup>2</sup> = 62%), suggesting variability in the study results, which could have been influenced by differences in the study design, population, and interventions. <b>Conclusions</b>: Although the results were statistically inconclusive and the estimates imprecise, the confidence intervals still span possible benefit and harm. Thus, while the current evidence does not support the routine use of cervical pessaries, it also does not indicate an increased risk of fetal or neonatal mortality.https://www.mdpi.com/2075-4418/15/12/1466cervical pessaryshort cervixperinatal mortalitypreterm birthsystematic review |
| spellingShingle | Henrique Graf Provinciatto Edward Araujo Júnior Gustavo Yano Callado Alan Roberto Hatanaka Roberto Angelo Fernandes Santos Evelyn Traina Gabriela Ubeda Santucci França Luiza Graça Coutinho Alan Lebrão de Amorim Lucas Almeida das Chagas Rosiane Mattar Marcelo Santucci França Pessary for Prevention of Preterm Birth and Perinatal Mortality in Pregnancies with a Short Cervix: Systematic Review and Meta-Analysis of Randomized Controlled Trials Diagnostics cervical pessary short cervix perinatal mortality preterm birth systematic review |
| title | Pessary for Prevention of Preterm Birth and Perinatal Mortality in Pregnancies with a Short Cervix: Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | Pessary for Prevention of Preterm Birth and Perinatal Mortality in Pregnancies with a Short Cervix: Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Pessary for Prevention of Preterm Birth and Perinatal Mortality in Pregnancies with a Short Cervix: Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Pessary for Prevention of Preterm Birth and Perinatal Mortality in Pregnancies with a Short Cervix: Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | Pessary for Prevention of Preterm Birth and Perinatal Mortality in Pregnancies with a Short Cervix: Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | pessary for prevention of preterm birth and perinatal mortality in pregnancies with a short cervix systematic review and meta analysis of randomized controlled trials |
| topic | cervical pessary short cervix perinatal mortality preterm birth systematic review |
| url | https://www.mdpi.com/2075-4418/15/12/1466 |
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