[Use of pessaries to prevent preterm birth: Are we going back to mechanical devices in obstetrics?].

AIM: To review the available data in the literature on the use of pessaries in preventing preterm birth.

MATERIALS AND

METHODS

We searched PubMed and the Cochrane library with pessary preterm birth.

RESULTS

Fifty-eight papers were identified, most of them with little scientific value. A randomized study, including 385 singleton pregnancies with a transvaginal ultrasound cervical length less than 25 mm between 18 and 22 WG, shows a reduction of spontaneous prematurity before 34 WG in the pessary group, with an OR of 0.18 (95%CI: 0.08-0.37). Another study on multiple pregnancies randomized between 12 and 20 WG, with a cervix measured by ultrasound between 16 and 22 WG, showed a reduction of neonatal morbidity in the pessary group (RR: 0.42; 95%CI: 0.19-0.91) in a sub-group with a cervical length<38 mm.

CONCLUSIONS

These first results from randomized controlled study are encouraging. Other studies on singleton and twin pregnancies are ongoing or about to start.