Effect of cervical pessary on pregnancy outcome in patients with twin pregnancies: a systematic review and meta-analysis

Author(s): Wang yue, Wu jiaxing, Ma di, Sun xin, Lin lin, Wang bo,Huang mingli

Background

Preterm birth is the main cause of child death under 5years of age. The incidence of twin pregnancies is less than 2%, but the incidence of preterm delivery is 50% and the risk of neonatal death is 5 times higher in twin pregnancies than in singleton pregnancies. However, there is still no consensus on the effect of cervical pessary on preventing preterm delivery, prolonging the pregnancy cycle, and improving maternal and infant outcomes in patients with twin pregnancies.

Objectives

To explore the effect of cervical pessary on the pregnancy outcome of unselected twin pregnancy patients.

Search Strategy Up to Jan 2022, researchers

Searched PubMed, EMBASE, COCHRANE, Web of Science, Wan fang, Weipu, and CNKI databases for research.

Study eligibility criteria

Randomized controlled trials that compared cervical pessary with standard care (no pessary) or alternative interventions (conventional and standard treatment (e.g.,Atoxiban therapy or vaginal progesterone) in patients with twin pregnancies.

Study appraisal and synthesis methods

Two authors independently extracted information related to the study characteristics and test results from each of the included literature, and used Revman 5.3 to analyze the data. Pooled relative risks with 95% confidence intervals were calculated. Cochrane collaborative tools were used to assess the risk of bias in individual studies. The main results were premature delivery at <34 weeks, preterm delivery <37 weeks, and abortion <28 weeks. Secondary results included spontaneous preterm delivery <34 weeks, spontaneous preterm delivery <34 weeks, spontaneous abortion <28 weeks, and preterm prelabour rupture of membranes <34 and preterm prelabour rupture of membranes, vaginal bleeding, chorioamnionitis, delivery week, vaginal infection