Cochrane · systematic review · CD014508
Cervical pessary for preventing preterm birth in singleton pregnancies
Abdel-Aleem, H, Shaaban, OM, Abdel-Aleem, MA, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
16
No studies
5
Included studies
NR
No studies 5 · 23.8%Ungraded 0 · 0%Very low 1 · 4.8%Low 11 · 52.4%Moderate 4 · 19%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Cervical pessary compared to no treatment for preventing preterm birth in singleton pregnancies
Population: women with singleton pregnancies at risk of cervical insufficiency
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Delivery before 34 weeks' gestation Cervical pessary vs no treatment | RR 0.72 [0.33, 1.55] | 5 studies · 1830 participants | Low Downgraded: imprecision, inconsistency |
Delivery before 37 weeks' gestation Cervical pessary vs no treatment | RR 0.68 [0.44, 1.05] | 5 studies · 1830 participants | Low Downgraded: imprecision, inconsistency |
Maternal infection or inflammation Cervical pessary vs no treatment | RR 1.04 [0.87, 1.26] | 2 studies · 1032 participants | Moderate Downgraded: risk of bias |
Neonatal/paediatric care unit admission Cervical pessary vs no treatment | RR 0.96 [0.58, 1.59] | 3 studies · 1332 participants | Low Downgraded: imprecision, inconsistency |
Fetal/infant mortality Cervical pessary vs no treatment | RR 0.93 [0.58, 1.48] | 5 studies · 1830 participants | Low Downgraded: imprecision |
Harm to offspring from the intervention Cervical pessary vs no treatment | no estimate extracted | NR | No studies |
Birthweight Cervical pessary vs no treatment | no estimate extracted | NR | No studies |
Cervical pessary compared to vaginal progesterone for preventing preterm birth in singleton pregnancies
Population: women with singleton pregnancies at risk of cervical insufficiency
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Delivery before 34 weeks' gestation Cervical pessary vs vaginal progesterone | RR 0.72 [0.52, 1.02] | 3 studies · 1126 participants | Moderate Downgraded: imprecision |
Delivery before 37 weeks' gestation Cervical pessary vs vaginal progesterone | RR 0.89 [0.73, 1.09] | 3 studies · 1126 participants | Moderate Downgraded: imprecision |
Maternal infection or inflammation Cervical pessary vs vaginal progesterone | RR 0.95 [0.81, 1.12] | 2 studies · 265 participants | Moderate Downgraded: risk of bias |
Neonatal/paediatric care unit admission Cervical pessary vs vaginal progesterone | RR 0.98 [0.49, 1.98] | 1 study · 254 participants | Low Downgraded: imprecision |
Fetal/infant mortality Cervical pessary vs vaginal progesterone | RR 1.97 [0.5, 7.7] | 2 studies · 265 participants | Low Downgraded: imprecision |
Harm to offspring from the intervention Cervical pessary vs vaginal progesterone | no estimate extracted | 1 study · 11 participants | Low Downgraded: imprecision |
Birthweight Cervical pessary vs vaginal progesterone | no estimate extracted | NR | No studies |
Cervical pessary compared to cervical cerclage for preventing preterm birth in singleton pregnancies
Population: women with singleton pregnancies at risk of cervical insufficiency
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Delivery before 34 weeks' gestation Cervical pessary vs cervical cerclage | no estimate extracted | 1 study · 13 participants | Low Downgraded: imprecision |
Delivery before 37 weeks' gestation Cervical pessary vs cervical cerclage | RR 5.71 [0.33, 99.97] | 1 study · 13 participants | Low Downgraded: imprecision |
Maternal infection or inflammation Cervical pessary vs cervical cerclage | RR 0.23 [0.01, 4] | 1 study · 13 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal/paediatric care unit admission Cervical pessary vs cervical cerclage | no estimate extracted | NR | No studies |
Fetal/infant mortality Cervical pessary vs cervical cerclage | RR 0.38 [0.02, 7.93] | 1 study · 13 participants | Low Downgraded: imprecision |
Harm to offspring from the intervention Cervical pessary vs cervical cerclage | no estimate extracted | 1 study · 13 participants | Low Downgraded: imprecision |
Birthweight Cervical pessary vs cervical cerclage | no estimate extracted | NR | No studies |