Abstract
Introduction: Cervical cerclage and vaginal progesterone are two primary methods for preventing preterm birth. However, their effectiveness in preventing singleton pregnancies with a short cervical length is unclear. We compared the effects of cervical cerclage and vaginal progesterone on the mother and neonate in asymptomatic singleton pregnancies in women with a cervical length between 10–30 mm.Material and Methods: Asymptomatic singleton pregnant women with a cervical length of 10–30 mm, measured using transvaginal ultrasound at 12–26 weeks of gestation, who delivered at our hospital were enrolled. The primary outcome measure was preterm birth at <37, 34, 32, and 28 weeks of gestation. The secondary outcome measures were neonatal mortality, latency period from diagnosis to delivery, hemorrhage during delivery, birth weight, and cesarean delivery.Results: In the unadjusted analysis, the number of preterm births was significantly higher in the cerclage group than in the vaginal progesterone group. After multivariate adjustment for confounding factors, this relationship narrowed. The latency period from diagnosis to delivery was significantly prolonged.Conclusions: Cervical cerclage showed no benefit over vaginal progesterone in preventing preterm birth. However, it prolonged gestational age by 39 days compared to vaginal progesterone treatment.
451: Progesterone, cervical cerclage and cervical pessary for primary prevention of preterm birth in high risk singleton pregnancies: a systematic review and network meta-analysis
