Cervical pessary for preventing preterm birth.
Cochrane Database Syst Rev
; (9): CD007873, 2010 Sep 08.
Article
em En
| MEDLINE
| ID: mdl-20824869
ABSTRACT
BACKGROUND:
Preterm delivery is a major health problem and contributes to more than 50% of the overall perinatal mortality. Cervical incompetence is one of the common causes of preterm birth to which different management strategies have been tried including cervical cerclage. Cervical cerclage is an invasive technique that needs anaesthesia and may be associated with complications. Moreover, there is still a matter of controversy regarding the efficacy and the group of patients which could benefit from this operation. Cervical pessary has been tried as a simple, non-invasive alternative that might replace the above invasive cervical stitch operation.OBJECTIVES:
To evaluate the efficacy of cervical pessary for prevention of preterm birth in women with cervical incompetence. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (May 2010), Current Controlled Trials and the Australian New Zealand Clinical Trials Registry (May 2010). SELECTION CRITERIA We selected all published and unpublished randomised clinical trials comparing the use of cervical pessary with cervical cerclage or expectant management for prevention of preterm birth. We did not include quasi-randomised trials, cluster-randomised and crossover trials. DATA COLLECTION ANDANALYSIS:
Two review authors independently assessed trials for inclusion. MAINRESULTS:
The search identified two trials which we excluded. Three additional trials are ongoing. This review contains no included studies. AUTHORS'CONCLUSIONS:
The review did not identify any well-designed randomised clinical trial in order to confirm or refute the benefit of cervical pessary. However, there is evidence from non-randomised trials that showed some benefit of cervical pessary in preventing preterm birth. We are waiting for the results of three ongoing randomised controlled trials, assessing the role of cervical pessary in women with short cervix. There is a need for further well-designed randomised controlled trials.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Pessários
/
Nascimento Prematuro
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
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Systematic_reviews
Limite:
Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Cochrane Database Syst Rev
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
Ano de publicação:
2010
Tipo de documento:
Article