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Pregnant women

Combined Vaginal Progesterone and Cervical Pessary Reduces Preterm Birth in Singleton Pregnancies

Strategic Insights

— 2 min read

A recent study conducted at the University of Medical Sciences in Tehran, Iran, has found that the combination of vaginal progesterone and cervical pessary initiated during the second trimester significantly reduces the incidence of preterm birth and enhances neonatal outcomes among women diagnosed with singleton pregnancies and a short cervix. The study involved 322 pregnant individuals with singleton gestations and a sonographically confirmed short cervix, managed at Akbarabadi Hospital, a tertiary referral center. The participants were allocated into two treatment groups: one received both vaginal progesterone and an Arabin cervical pessary, and the other received progesterone alone.

Key Takeaways:

  • The combination of vaginal progesterone and cervical pessary significantly reduced the incidence of preterm birth before 34 weeks (3.1% vs. 12.4%; p = 0.002) and before 37 weeks (22.4% vs. 37.3%; p = 0.003).
  • The combination group showed better neonatal outcomes, including fewer NICU admissions (34.8% vs. 54.0%; p = 0.012), shorter NICU stays, and a lower need for resuscitation.
  • Maternal complications, including postpartum hemorrhage, infection, and ICU admissions, were noticeably lower in the combination group (2.5% vs. 10.6%; p = 0.003).
  • The study suggests that dual therapy may reduce preterm birth risk, but confirmation in prospective randomized trials is warranted.
  • The research found that combining vaginal progesterone with a cervical pessary during mid-pregnancy can significantly reduce the risk of preterm birth and improve outcomes for both mother and baby in singleton pregnancies with a short cervix.
  • The study's results support incorporating dual therapy into clinical practice guidelines as an effective approach to preventing preterm birth in high-risk populations.

Statistics:

  • 322 pregnant individuals with singleton gestations and a short cervix were involved in the study.
  • The combination group had a 3.1% incidence of preterm birth before 34 weeks, compared to 12.4% in the progesterone-only group.
  • The combination group had a 22.4% incidence of preterm birth before 37 weeks, compared to 37.3% in the progesterone-only group.
  • The combination group had fewer NICU admissions (34.8% vs. 54.0%).
  • The combination group had shorter NICU stays, with 66% of patients discharged within 3 days, compared to 34% in the progesterone-only group.
  • The combination group had a lower need for resuscitation (5.6% vs. 12.4%).

Sources:

  • Combined vaginal progesterone and cervical Pessary effect on preterm birth in Singleton pregnancies with short cervix: a retrospective cohort study. BMC Pregnancy and Childbirth, 2025;25(1):1055. BMC Pregnancy and Childbirth can be contacted at: Bmc, Campus, 4 Crinan St, London N1 9XW, England. (BioMed Central - www.biomedcentral.com/; BMC Pregnancy and Childbirth - www.biomedcentral.com/bmcpregnancychildbirth/)
  • Fatemeh Jayervand, Dept. of Gynecology and Obstetrics, School of Medicine, University Medical Sciences, Tehran, Iran.

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