[Cervical pessary and spontaneous preterm birth].
OBJECTIVE
To determine the efficacy of the cervical pessary for the prevention of preterm delivery and to propose recommendations.


METHODS
We searched the MedLine and the Cochrane Library and checked the international guidelines: ACOG and SOGC.


RESULTS
The data concerning the efficacy of the cervical pessary for the prevention of preterm birth in a population of asymptomatic women with a singleton pregnancy with a short cervix≤25mm between 20 and 24 weeks 6 days of gestation and in a population of asymptomatic women with a twin pregnancy at high risk of preterm delivery defined by a short cervix are contradictory. More studies are necessary to recommend its use in these indications (Professional consensus). A cervical pessary placed before 22 weeks of gestation does not reduce the risk of preterm birth in the general population of asymptomatic women with a twin pregnancy (EL1). It is therefore not recommended to use the cervical pessary in order to prevent preterm delivery in the general population of asymptomatic women with a twin pregnancy (grade A).


CONCLUSIONS
More studies are necessary to recommend the use of the cervical pesssary in singleton and in twin pregnancies with a short cervix.
Service de gynécologie-obstétrique, maternité, Centre Aliénor d'Aquitaine, groupe hospitalier Pellegrin, université de Bordeaux, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France. Electronic address: stephanie.brun@chu-bordeaux.fr.
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D002584:Cervix Uteri; D005260:Female; D006801:Humans; D010570:Pessaries; D011247:Pregnancy; D059285:Pregnancy, Twin; D047928:Premature Birth / Q000517:prevention & control*
Cervical pessary; Pessaire cervical; Preterm birth; Prevention; Prématurité; Prévention