- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Cervical pessaries fail to prevent preterm birth among individuals with short cervix
In an effort to address the established risk of preterm birth associated with a short cervix, a recent study published in the Journal of Association Medical Association found that cervical pessaries did not reduce the risk of preterm delivery, it was associated with an increased risk of fetal or neonatal/infant mortality.
Conducted between February 2017 and November 2021 across 12 centers in the US, the randomized, unmasked trial enrolled nonlaboring individuals with singleton pregnancies and a transvaginal ultrasound cervical length of 20 mm or less at gestations of 16 weeks 0 days through 23 weeks 6 days. Notably, individuals with a prior spontaneous preterm birth were excluded from the study.
A total of 544 participants were enrolled in the study, representing 64% of the originally planned sample size of 850. The mean age of participants was 29.5 years. Half of the participants were randomly assigned to receive a cervical pessary, while the other half received usual care. Additionally, 98.9% of the participants received vaginal progesterone at the discretion of their treating clinicians.
The primary outcome of interest was the occurrence of delivery or fetal death prior to 37 weeks of gestation. Surprisingly, the results of the study did not show a significant difference in the risk of preterm birth between those who received a cervical pessary and those who received usual care. The primary outcome occurred in 45.5% of participants who received the pessary and 45.6% of those who received usual care, with a relative risk of 1.00.
However, the study's most concerning finding was related to fetal or neonatal/infant mortality rates. Among those who received the cervical pessary, the rate of fetal or neonatal/infant death was 13.3%, compared to 6.8% in the usual care group. This resulted in a relative risk of 1.94, indicating a higher mortality risk associated with the pessary.
Due to these concerning findings and the interim analysis results, the study recruitment was halted. The researchers expressed concerns over both fetal/neonatal mortality and futility, highlighting the lack of significant benefit in using cervical pessaries to prevent preterm birth in the specific group of nonlaboring individuals with a singleton pregnancy and a short cervix.
Reference:
Hoffman, M. K., Clifton, R. G., Biggio, J. R., Saade, G. R., Ugwu, L. G., Longo, M., Bousleiman, S. Z., Clark, K., Grobman, W. A., Frey, H. A., Chauhan, S. P., Dugoff, L., Simhan, H. N., Esplin, M. S., Macones, G. A., … Bickus, M. T. (2023). Cervical Pessary for Prevention of Preterm Birth in Individuals With a Short Cervix. In JAMA (Vol. 330, Issue 4, p. 340). American Medical Association (AMA). https://doi.org/10.1001/jama.2023.10812
Neuroscience Masters graduate
Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751