Unraveling the Efficacy of Therapeutic Interventions for Short Cervix: Insights from a Retrospective Study for Improved Clinical Management

• Published in: Medicina (Kaunas, Lithuania) Vol. 59; no. 6; p. 1018
• Main Authors: Luca, Alina-Madalina, Bernad, Elena, Nemescu, Dragos, Vaduva, Cristian, Harabor, Anamaria, Adam, Ana-Maria, Harabor, Valeriu, Nechita, Aurel, Strobescu, Cristina, Mogos, Raluca, Carauleanu, Alexandru, Vasilache, Ingrid-Andrada, Socolov, Demetra
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24.05.2023; MDPI
• Subjects: Asymptomatic; Autoimmune diseases; Care and treatment; Cerclage, Cervical; Cerebral palsy; cervical cerclage; Cervix; Cervix Uteri; Cesarean section; Female; Health aspects; Humans; Hydroxyprogesterone; Infant, Newborn; Infants; Infants (Premature); Medical records; Observational studies; Patient outcomes; Patients; pessary; Pregnancy; Pregnancy complications; Pregnant women; Premature birth; Premature Birth - epidemiology; Premature Birth - prevention & control; preterm birth; Progesterone; Progesterone - therapeutic use; Retrospective Studies; Sutures; Ultrasonic imaging; Vagina; Womens health; Romania; United States > US; preterm birth; cervical cerclage; pessary; progesterone
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina59061018

: Preterm birth (PTB) is associated with important neonatal mortality and morbidity. The aim of this study was to retrospectively evaluate the average treatment effects on the treated and the efficacity of various therapeutic interventions for PTB in a cohort of patients with singleton pregnancies and short cervical lengths. : This observational retrospective study included 1146 singleton pregnancies at risk of PTB that were segregated into the following groups: intravaginal progesterone (group 1), Arabin pessary (group 2), McDonald cerclage (group 3), intravaginal progesterone and Arabin pessary (group 4), and intravaginal progesterone and cerclage (group 5). Their treatment effects were evaluated and compared. : All evaluated therapeutic interventions significantly reduced the occurrence of late and early preterm births. The risk of late and early PTB was lowered for those pregnant patients who received progesterone and pessaries or progesterone and cerclage in comparison with those who received only progesterone. The extremely PTB risk of occurrence was significantly lowered only by the administration of progesterone in association with cervical cerclage in comparison with progesterone monotherapy. : The combined therapeutic interventions had the highest efficacy in preventing preterm birth. An individualized evaluation is needed to establish the best therapeutic approach in particular cases.