scholarly journals Cervical Pessaries for the Prevention of Preterm Birth: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Sophie M. S. Liem ◽  
Mariëlle G. van Pampus ◽  
Ben Willem J. Mol ◽  
Dick J. Bekedam

Introduction. Reduction of preterm birth is a major goal in obstetric care. We performed a systematic review of randomized controlled trials and cohort studies on the effectiveness of the cervical pessary to prevent preterm birth.Methods. We searched the electronic databases of MEDLINE and Embase from inception until April 2012 to identify studies investigating treatment with a cervical pessary to prevent preterm birth. We constructed two-by-two tables for delivery before 28, 34, and 37 weeks of gestation and calculated relative risks (RRs) with 95% confidence intervals.Results. The search revealed 103 potentially eligible abstracts of which six cohort studies and four randomized controlled trials (RCTs) investigated the effectiveness of the pessary. One RCT (n=380) demonstrated a lower delivery rate prior to 34 weeks (RR 0.24; 95% CI 0.13–0.43) in the pessary group, while another RCT (n=108) showed no positive effect of pessary for delivery before 34 weeks (RR 1.73; 95% CI 0.43–6.88). Two older quasi randomized studies and cohort studies indicated potential effect of the pessary.Conclusions. Available randomized and nonrandomized studies indicate potential effectiveness of a cervical pessary in the prevention of preterm birth. More randomized clinical trials are needed before this device can be used in clinical practice.




2020 ◽  
Vol 9 (4) ◽  
pp. 1038 ◽  
Author(s):  
Ruben D. Hidalgo-Agudo ◽  
David Lucena-Anton ◽  
Carlos Luque-Moreno ◽  
Alberto Marcos Heredia-Rizo ◽  
Jose A. Moral-Munoz

Parkinson’s disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to conventional physical therapy in Parkinson’s disease. A systematic review and meta-analysis of randomized controlled trials were performed. The literature search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), Scopus, SciELO and Web of Science. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 11 randomized controlled trials were included in this review. Five of them contributed information to the meta-analysis. The statistical analysis showed favorable results for dance-based therapy in motor balance: (Timed Up and Go: standardized mean difference (SMD) = −1.16; 95% Confidence Interval (CI):(−2.30 to −0.03); Berg Balance Scale: SMD = 4.05; 95%CI:(1.34 to 6.75)). Aquatic interventions showed favorable results in balance confidence (Activities-Specific Balance Confidence: SMD=10.10; 95%CI:(2.27 to 17.93)). The results obtained in this review highlight the potential benefit of dance-based therapy in functional balance for people with Parkinson’s disease, recommending its incorporation in clinical practice. Nonetheless, many aspects require clarification through further research and high-quality studies on this subject.



2016 ◽  
Vol 215 (5) ◽  
pp. 561-571 ◽  
Author(s):  
Daniele Di Mascio ◽  
Elena Rita Magro-Malosso ◽  
Gabriele Saccone ◽  
Gregary D. Marhefka ◽  
Vincenzo Berghella




2017 ◽  
Vol 96 (3) ◽  
pp. 263-273 ◽  
Author(s):  
Elena Rita Magro-Malosso ◽  
Gabriele Saccone ◽  
Daniele Di Mascio ◽  
Mariarosaria Di Tommaso ◽  
Vincenzo Berghella


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