Preventing preterm birth in high-risk pregnant women: cerclage or Pessary? A retrospective cohort study

Resumen

Although preterm birth is considerably more prevalent in pregnant women with a history of previous preterm birth, there is no universal consensus on how to prevent preterm birth in high-risk pregnant women individually. Pessary and cerclage are currently among the two main approaches for preventing preterm birth; however, each method's effectiveness in different high-risk pregnant women is relatively unknown. Therefore, the present study compared the use of cerclage and pessary as methods to prevent preterm birth in high-risk pregnant women. In the current retrospective cohort study, data regarding 88 high-risk pregnant women who were admitted to Kamali Hospital, Karaj, Iran, and had short cervical lengths were collected. Each pregnant woman was either implanted with a pessary or had a cerclage performed. Regression modeling was performed to adjust for the possible confounders, and the odds of preterm birth before the 37th week in each treatment group was calculated. The regression modeling showed that pregnant women who received a pessary implant had lower odds of preterm birth (OR=0.3, 95%CI= 0.1-0.9, p<0.05). Age, gestational age, and cervical length at the time of receiving treatment were considered as the confounding variables. The present study shows that pessary is a more effective method for preventing preterm birth in high-risk pregnant women with cervical lengths ≤25 mm in comparison to the cerclage.