title: Cervical pessary for preventing preterm birth.
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.
  
  
  OBJECTIVE
  To evaluate the efficacy of cervical pessary for prevention of preterm birth in women with cervical incompetence.
  
  
  METHODS
  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).
  
  
  METHODS
  We selected all published and unpublished randomised clinical trials comparing the use of cervical pessary with cervical cerclage or expectant management for prevention of preterm birth.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.
  
  
  METHODS
  Two review authors independently assessed trials for inclusion.
  
  
  RESULTS
  The search identified two trials which we excluded. Three additional trials are ongoing. This review contains no included studies.
  
  
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt, 71511.
authors.forename: Hany
authors.initials: H
authors.lastname: Abdel-Aleem
authors.forename: Omar M
authors.initials: OM
authors.lastname: Shaaban
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Abdel-Aleem
mesh_terms: D005260:Female; D006801:Humans; D010570:Pessaries; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control*