Comparison the efficacy of vaginal progesterone versus 17-alpha-hydroxyprogesterone caproate to prevent preterm birth in high-risk pregnant women undergo cerclage: a randomized clinical trial

2021 ◽  
pp. 1-7
Author(s):  
Azin Alavi ◽  
Amene Ranjbar ◽  
Farzane Atighpoor ◽  
Shahram Zare
Keyword(s):  
Clinical Trial ◽  
Preterm Birth ◽  
High Risk ◽  
Pregnant Women ◽  
Randomized Clinical Trial ◽  
Vaginal Progesterone ◽  
Hydroxyprogesterone Caproate

scholarly journals Comparing Efficacy of Cerclage and Adjunctive Therapy (Cerclage & Pessary) in Prevention of Preterm Birth in Pregnant Women with Cervical Insufficiency: A Randomized Clinical Trial.

2020 ◽  
Author(s):  
Mitra Arjmandifar ◽  
Maryam Moshfeghi ◽  
Maryam Mohammadi ◽  
Mahya Eftekhari
Keyword(s):  
Clinical Trial ◽  
Survival Analysis ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Randomized Clinical Trial ◽  
Gestational Age ◽  
Adjunctive Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Cervical Insufficiency

Abstract Background: Cervical insufficiency is the responsible factor for 15-25% of pregnancy loss in the second trimester. Midwifery specialists sometimes prefer to use adjunctive therapy in combination with cerclage surgery for management of cervical insufficiency. The aim of this study was to evaluate the effectiveness of adjunctive pessary therapy after cerclage in improving perinatal and neonatal outcome and increasing satisfaction in women with cervical insufficiency.Methods: This concurrent randomized clinical trial was conducted at the infertility department of Royan Institute, Tehran, Iran from May 2018 to May 2020. In this trial, 170 singleton pregnant women, diagnosed with cervical insufficiency, of gestational age 14 to 26 weeks, were enrolled. Patients were randomized 1:1 to receive either cervical cerclage or pessary after cerclage. The primary outcomes were gestational age at the time of delivery and the percentage of preterm labor (<37 weeks). The secondary outcomes were the method of delivery, neonatal outcomes, maternal adverse events and maternal satisfaction of interventions.Results: Preterm birth before 37 weeks of gestation occurred in 16 women (19.3%) in the pessary group and 17 women (21%) in the control group (between-group difference, 1.11%; 95%CI 0.518−2.388%). In the survival analysis to 37 WK of gestation, the incidence of preterm birth was not significantly different between the two groups (Relative Risk (RR), 1; 95%CI, 0.161-6.202). Based on survival analysis, the incidence of vaginal bleeding and pelvic pain significantly differed between the two groups (RR, 2.68; 95%CI (1.31-5.46)) and (RR, 1.73; 95%CI (1.04-2.87), respectively. The mean score of satisfaction in the intervention group (5.73) was significantly higher than the control group (5.25), (between-group difference, 0.47; 95%CI (0.10-0.84).Conclusions: The placement of an adjunctive pessary for pregnant women with singleton pregnancy and a cervical insufficiency, did not result in a lower rate of preterm delivery before 37 weeks of gestation compared to cerclage alone. However, the complications of pregnancy after the intervention until delivery, were less in these women, while the level of satisfaction was higher. Trial registration: Iranian Registry of Clinical Trials (IRCT20180302038914N1), May 5,2018.

The effect of folic acid throughout pregnancy among pregnant women at high risk of pre-eclampsia: A randomized clinical trial

2020 ◽  
Vol 19 ◽  
pp. 253-258
Author(s):  
Lili Zheng ◽  
Jing Huang ◽  
Hongfang Kong ◽  
Fang Wang ◽  
Yuan Su ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Folic Acid ◽  
High Risk ◽  
Pregnant Women ◽  
Randomized Clinical Trial

Combined treatment with cervical pessary and vaginal progesterone for the prevention of preterm birth: A randomized clinical trial

2016 ◽  
Vol 42 (12) ◽  
pp. 1673-1679 ◽  
Author(s):  
Niloofar Karbasian ◽  
Mahdi Sheikh ◽  
Reihaneh Pirjani ◽  
Shahla Hazrati ◽  
Fatemeh Tara ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Preterm Birth ◽  
Randomized Clinical Trial ◽  
Combined Treatment ◽  
Cervical Pessary ◽  
Vaginal Progesterone
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