SynthesisAmerican journal of obstetrics and gynecology2013
Vaginal progesterone vs. cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix, previous preterm birth, and singleton gestation: a systematic review and indirect comparison metaanalysis.
Synthesis in American journal of obstetrics and gynecology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 65 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Trial of Pessary in Singleton Pregnancies With a Short Cervix
Cervical Cerclage Plus Vaginal Progesterone Versus Vaginal Progesterone Alone in Twin Pregnancies With a Short Cervix for Prevention of Preterm Birth: a Randomized Controlled Trial
Who cites it
65 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- Pooled it
- Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies.The Cochrane database of systematic reviews · 2020Pooled it
- Cervical pessary to prevent preterm birth in asymptomatic high-risk women: a systematic review and meta-analysis.American journal of obstetrics and gynecology · 2020Pooled it
- The use of progesterone during pregnancy to prevent preterm birth.Saudi medical journal · 2020Pooled it
- The use of specialised preterm birth clinics for women at high risk of spontaneous preterm birth: a systematic review.BMC pregnancy and childbirth · 2020Pooled it
- Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis.American journal of obstetrics and gynecology · 2018Pooled it
- Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data.American journal of obstetrics and gynecology · 2018Pooled it
- Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy.The Cochrane database of systematic reviews · 2017Pooled it
- Predictive accuracy of changes in transvaginal sonographic cervical length over time for preterm birth: a systematic review and metaanalysis.American journal of obstetrics and gynecology · 2015Pooled it
- Prenatal administration of progesterone for preventing preterm birth in women considered to be at risk of preterm birth.The Cochrane database of systematic reviews · 2013Pooled it
- Cluster Randomized Controlled Trial of Group Prenatal Care: Perinatal Outcomes Among Adolescents in New York City Health Centers.American journal of public health · 2016Trial
- Role of vulvovaginal infection in women with short cervix: An observational clinical trial.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Observational
- Human Papillomavirus in Reproductive Health and Pregnancy: Clinical Implications, Outcomes, and a Comprehensive Review of Vaccination.Vaccines · 2026Review
- Evaluation of the effects of indomethacin tocolytic treatment on fetal heart using modified myocardial performance index (Mod-MPI).BMC pregnancy and childbirth · 2025Article
- Risk factors for spontaneous preterm birth are mediated through changes in cervical length.Communications medicine · 2025Article
- Review
- LncRNA-mRNA regulatory network reveals key lncRNAs tightly associated with preterm labor and premature rupture of membranes.Non-coding RNA research · 2025Article
- Vaginal Progesterone Effects on Ultrasound Indices, Fetal Outcomes, and Preeclampsia in High-risk Pregnancy : Vaginal Progesterone in High-risk Pregnancy: Ultrasound Indices and Outcomes.Galen medical journal · 2025Article
- Characterization of Vaginal Microbial Colonization in Cervical Insufficiency Patients and Its Relation to Preterm Birth: An Observational Cohort Study.Journal of pregnancy · 2025Observational
- Changing Indications for Cervical Cerclage Following the Introduction of Routine Ultrasound Surveillance of Cervical Length for Prediction and Prevention of Preterm Birth.International journal of women's health · 2024Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
objectiveNo randomized controlled trial has compared vaginal progesterone and cervical cerclage directly for the prevention of preterm birth in women with a sonographic short cervix in the mid trimester, singleton gestation, and previous spontaneous preterm birth. We performed an indirect comparison of vaginal progesterone vs cerclage using placebo/no cerclage as the common comparator. STUDY
designAdjusted indirect metaanalysis of randomized controlled trials.
resultsFour studies that evaluated vaginal progesterone vs placebo (158 patients) and 5 studies that evaluated cerclage vs no cerclage (504 patients) were included. Both interventions were associated with a statistically significant reduction in the risk of preterm birth at <32 weeks of gestation and composite perinatal morbidity and mortality compared with placebo/no cerclage. Adjusted indirect metaanalyses did not show statistically significant differences between vaginal progesterone and cerclage in the reduction of preterm birth or adverse perinatal outcomes.
conclusionBased on state-of-the-art methods for indirect comparisons, either vaginal progesterone or cerclage are equally efficacious in the prevention of preterm birth in women with a sonographic short cervix in the mid trimester, singleton gestation, and previous preterm birth. Selection of the optimal treatment needs to consider adverse events, cost and patient/clinician preferences.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.