Cervical pessary in the prevention of preterm births in multiple pregnancies with a short cervix: PRISMA compliant systematic review and meta-analysis

Abstract

Background: Preterm births occur frequently in multiple pregnancies with a short cervix. The cervical pessary is a potential intervention for prevention of preterm births.

Objective: To assess the effectiveness of cervical pessary in the prevention of preterm births in multiple pregnancies with a short cervix (<25 mm).

Search strategy: Major databases from 2006 to 20th November 2016 were searched for relevant terms.

Selection criteria: We included randomized controlled trials that assessed the effectiveness of cervical pessary on pregnancy outcomes in multiple pregnancies with a short cervix.

Data collection and analysis: Risk ratio was used as the summary measure with random effects model. We assessed heterogeneity between studies using the I² index. Quality assessment was done based on Cochrane Handbook Method.

Main results: Pooled data showed no benefit of using cervical pessary in the prevention of preterm births, birth weights less than 1500 g, less than 2500 g, adverse neonatal events and fetal/neonatal deaths in twin pregnancies with a short cervix.

Conclusion: We are unable to show benefit of using cervical pessary in preventing preterm births in twin pregnancies with a short cervix. However, as cervical pessary is a reasonable intervention, there is a need for more randomized controlled trials in this area.

Keywords:

• Cervical pessary
• preterm birth
• multiple pregnancies
• short cervix
• systematic review

Acknowledgements

We would like to acknowledge the International Medical University, Malaysia Library services for providing us with access to databases used in this review.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

No funding was sought for this review.