Preterm Birth Clinical Trial
The incidence of multiple gestations has increased over the past years, mostly because of
increased use of assisted reproductive technologies. Triplet pregnancies are at increased
risk of preterm birth (PTB), which is the primary reason for their increased morbidity and
mortality compared to singletons. Multiple gestations, including triplets, account for about
3% of all pregnancies in the US but constitute at least 10% of cases of PTB, over 30% of very
low birth weight infants, and nearly 20% of infant mortality.
A short cervical length (CL) on transvaginal ultrasound (TVU) has been shown to be a good
predictor of PTB, including in multiple gestations. In singletons with a prior PTB and a
short CL <25mm before 24weeks, cerclage is associated with significant decreases in PTB and
perinatal morbidity and mortality in the meta-analysis of randomized trials (RCTs). On the
contrary, the effect of cerclage in multiple gesttations has been insufficiently studied,
with meta-analysis data showing a possible harm from cerclage compared to controls.
The aim of this RCT is to evaluate the efficacy of cervical pessary in prevention of PTB in
unselected triplet gestations.
We planned to assess outcomes in subgroup analysis of women with short cervical length (TVU
CL <30 mm)
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|---|---|---|---|
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