Cervical pessary and prevention of preterm birth

Cervical pessary is a promising tool to prevent preterm birth in high risk pregnant women with shortened midtrimester ultrasonographic cervical length. It is well tolerated by women. PECEP and ProTWIN trials have opened new fields of clinical research. Their results suggest that cervical pessary may prevent preterm birth in women with (i) singleton and cervical length <= 25 mm at 18-22 weeks, and with (ii) twins and cervical length <= 37 mm at 16-22 weeks. These results must be confirmed by other randomized controlled trial before a generalization of cervical pessary in these situations. The role of cervical pessary in the existing strategies to prevent birth (progesterone, cerclage or combinations thereof) has to be determined. (C) 2013 Elsevier Masson SAS. All rights reserved.