title: Cervical pessaries for prevention of spontaneous preterm birth: past, present and future.
abstract: This Review describes the rationale for the use of cervical pessaries to prevent spontaneous preterm birth and their gradual introduction into clinical practice, discusses technical aspects of the more commonly used designs and provides guidance for their use and future evaluation. Possible advantages of cervical pessaries include the easy, 'one-off' application, good side-effect profile, good patient tolerance and relatively low cost compared with current alternatives. Use of transvaginal sonography to assess cervical length in the second trimester allows much better selection of patients who may benefit from the use of a cervical pessary, but future clinical trials are needed to establish clearly the role of pessaries as a preterm birth prevention strategy worldwide.
authors.affiliation: Centre for Mother and Child of the Philipps University Marburg, Marburg, Germany; Clara Angela Foundation, Witten, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Arabin
authors.forename: Z
authors.initials: Z
authors.lastname: Alfirevic
mesh_terms: D001706:Biopsy; D004867:Equipment Design; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000517:prevention & control; D006760:Hospitalization; D006801:Humans; D010353:Patient Education as Topic; D010570:Pessaries; D011247:Pregnancy; D059285:Pregnancy, Twin; D047928:Premature Birth / Q000000981:diagnostic imaging / Q000517:prevention & control*; D016216:Ultrasonography, Prenatal; D002577:Uterine Cervical Diseases / Q000000981:diagnostic imaging / Q000517:prevention & control*
keywords: cervical pessary; polyclinic setting; spontaneous preterm birth; transvaginal sonography in obstetrics