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Title: Cervical pessary placement for prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial.
Authors: Nicolaides, Kypros H
Syngelaki, Argyro
Poon, Liona C
de Paco Matallana, Catalina
Plasencia, Walter
Molina, Francisca S
Picciarelli, Gemma
Tul, Natasa
Celik, Ebru
Lau, Tze Kin
Conturso, Roberto
Keywords: Arabin pessary;cervical length;neonatal morbidity;prematurity;preterm birth;sonographic short cervix;twins
metadata.dc.subject.mesh: Adult
Cervix Uteri
Enterocolitis, Necrotizing
Infant, Newborn
Intention to Treat Analysis
Intracranial Hemorrhages
Perinatal Death
Pregnancy, Twin
Premature Birth
Respiratory Distress Syndrome, Newborn
Retinopathy of Prematurity
Watchful Waiting
Issue Date: 28-Aug-2015
Abstract: Preterm birth is the leading cause of neonatal death and handicap in survivors. Although twins are found in 1.5% of pregnancies they account for about 25% of preterm births. Randomized controlled trials in singleton pregnancies reported that the prophylactic use of progestogens, cervical cerclage and cervical pessary reduce significantly the rate of early preterm birth. In twin pregnancies, progestogens and cervical cerclage have been shown to be ineffective in reducing preterm birth. The objective of this study was to test the hypothesis that the insertion of a cervical pessary in twin pregnancies would reduce the rate of spontaneous early preterm birth. This was a multicenter, randomized controlled trial in unselected twin pregnancies of cervical pessary placement from 20(+0)-24(+6) weeks' gestation until elective removal or delivery vs. expectant management. Primary outcome was spontaneous birth A total of 1,180 (56.0%) of the 2,107 eligible women agreed to take part in the trial; 590 received cervical pessary and 590 had expectant management. Two of the former and one of the latter were lost to follow up. There were no significant differences between the pessary and control groups in rates of spontaneous birth In women with twin pregnancy, routine treatment with cervical pessary does not reduce the rate of spontaneous early preterm birth.
metadata.dc.identifier.doi: 10.1016/j.ajog.2015.08.051
Appears in Collections:Producción 2020

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