What is it about?
Women who are pregnant with twins or more have a higher risk of giving birth too early, especially if they also have a short cervix (the lower part of the uterus). This can cause serious health problems for their babies or even death. Two treatments are often used to try to prevent early birth: Vaginal progesterone (a hormone given as a gel or capsule), and A cervical pessary (a silicone ring placed around the cervix). It was not clear which treatment works better. In our study, we compared these two treatments to find out if a cervical pessary is more effective than vaginal progesterone in preventing preterm birth in women with a multiple pregnancy and a short cervix.
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Why is it important?
In women with a twin or multiple pregnancy, we still do not know the best way to treat those who have a short cervix, even though they have a higher risk of giving birth before 37 weeks of pregnancy. This is called preterm birth. Babies who are born too early have a higher risk of dying or developing serious health problems, some of which can have long-term consequences.
Perspectives
This study contributes to the ongoing effort to better identify which subgroups of patients benefit from specific treatments and which do not. Earlier research often grouped all patients together, but this approach is too general. In the future, an individualised treatment plan and personalised risk assessment would be the most optimal approach. This study takes a step in that direction by focusing on a specific group, those with a multiple pregnancy and a short cervix. It shows that a cervical pessary does not work better than progesterone and may even involve more risks.
Charlotte van Dijk
Amsterdam University Medical Centers
Read the Original
This page is a summary of: Cervical pessary versus vaginal progesterone in women with a multiple pregnancy and a short cervix: A randomised controlled trial, PLoS Medicine, November 2025, PLOS,
DOI: 10.1371/journal.pmed.1004586.
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