The efficacy of cervical cerclage combined with a pessary for the prevention of spontaneous preterm birth

Abstract

Aims This study compared the effectiveness and safety of cervical cerclage combined with cervical pessary in the treatment of cervical incompetence and that of cervical cerclage alone and cervical pessary alone. Methods We performed a prospective cohort study of women with cervical incontinence. Subjects were randomized into three groups: cerclage, pessary, and cerclage and pessary combined. Results A total of 75 patients with cervical incompetence were enrolled: 37.3% patients had a cervical length <15 mm, and 62.5% had a cervical length of 15–25 mm. Patients with increased body mass index were significantly likely to have a short cervix (p = .06); patients with a short cervix had earlier rupture of the membrane. The cerclage and pessary groups had more spontaneous abortions than the combined treatment group, which had no abortions or premature births. The mean gestational ages at delivery for the cerclage group (37.82 weeks) and the pessary group (35.73 weeks) were smaller than for the combined treatment group (38.33 weeks). The premature rupture of membranes that was correlated with cervical length had a higher incidence in the pessary group (26.9%). Conclusion Placement of a cervical cerclage combined with a cervical pessary is a safe technique and has a high success rate in the treatment of cervical incompetence.