Effectiveness of preventive interventions in women with multiple pregnancy and sonographically short cervix
A prospective study was conducted in 218 women with twin pregnancy and a sonographic short cervix ≤25 mm, which were divided into 4 groups: 1st group (control, n=36) - a watchful waiting strategy, 2nd group (n=65) - installation of a pessary in combination with progesterone, 3rd group (n=49) - intravaginaly micronized progesterone and 4th group (n=69) - installation of a cervical pessary. Intravaginal use of progesterone in women with multiple pregnancy does not reduce the level of preterm birth, but in comparison to a watchful waiting strategy is accompanied with an improvement of secondary consequences: birth of children with small body weight and presence of respiratory disorders. The use of a pessary alone was associated with an increase in the duration of the latent period from the establishment of the diagnosis to delivery by an average of 12.9% (p=0.016). In case of women with sonographic short cervix and with multiple pregnancy, pessaries can be used in combination with vaginal progesterone, considering the possible summation of the positive effects of each of the interventions used.
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