title: [Use of pessaries to prevent preterm birth: Are we going back to mechanical devices in obstetrics?].
abstract: OBJECTIVE
  To review the available data in the literature on the use of pessaries in preventing preterm birth.
  
  
  METHODS
  We searched PubMed and the Cochrane library with pessary preterm birth.
  
  
  RESULTS
  Fifty-eight papers were identified, most of them with little scientific value. A randomized study, including 385 singleton pregnancies with a transvaginal ultrasound cervical length less than 25 mm between 18 and 22 WG, shows a reduction of spontaneous prematurity before 34 WG in the pessary group, with an OR of 0.18 (95%CI: 0.08-0.37). Another study on multiple pregnancies randomized between 12 and 20 WG, with a cervix measured by ultrasound between 16 and 22 WG, showed a reduction of neonatal morbidity in the pessary group (RR: 0.42; 95%CI: 0.19-0.91) in a sub-group with a cervical length<38 mm.
  
  
  CONCLUSIONS
  These first results from randomized controlled study are encouraging. Other studies on singleton and twin pregnancies are ongoing or about to start.
authors.affiliation: Service de gynécologie obstétrique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: A-C
authors.initials: AC
authors.lastname: Denormandie
authors.affiliation: Service de gynécologie obstétrique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 83, boulevard de l'Hôpital, 75013 Paris, France; Inserm U1150, CNRS UMR 7222, université Sorbonne, UPMC université Paris 06, 75005 Paris, France. Electronic address: jacky.nizard@psl.aphp.fr.
authors.forename: J
authors.initials: J
authors.lastname: Nizard
mesh_terms: D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D010570:Pessaries; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control*; D014463:Ultrasonography
keywords: Avortement tardif; Cervical incompetency; Incompétence cervicale; Pessaire; Pessary; Prematurity; Prématurité; Second trimester miscarriage