Evidence map›Paper›PMID 38655568›Full record

ReviewAJOG global reports2024

The effect of cervical pessary on increasing gestational age at delivery in twin pregnancies with asymptomatic short cervix: a systematic review and meta-analysis of randomized controlled trials.

Amir Hossein Norooznezhad, Nikan Zargarzadeh, Ali Javinani, Seyedeh Maedeh Nabavian, Shohra Qaderi, Shayan Mostafaei, Vincenzo Berghella, Yinka Oyelese, Alireza A Shamshirsaz

Open access · goldAbstract readReview
In one paragraph

Review in AJOG global reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Prevention of preterm birth in twin pregnancy: international Delphi consensus.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 3 countries.

Amir Hossein NorooznezhadMedical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran (Dr. Norooznezhad and Dr. Nabavian).
Nikan ZargarzadehMaternal Fetal Care Center, Division of Maternal Fetal Medicine and Surgery, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA (Dr. Zargarzadeh, Dr. Javinani, Dr. Qaderi, Dr. Oyelese, and Dr Shamshirsaz).
Ali JavinaniMaternal Fetal Care Center, Division of Maternal Fetal Medicine and Surgery, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA (Dr. Zargarzadeh, Dr. Javinani, Dr. Qaderi, Dr. Oyelese, and Dr Shamshirsaz).
Seyedeh Maedeh NabavianMedical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran (Dr. Norooznezhad and Dr. Nabavian).
Shohra QaderiMaternal Fetal Care Center, Division of Maternal Fetal Medicine and Surgery, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA (Dr. Zargarzadeh, Dr. Javinani, Dr. Qaderi, Dr. Oyelese, and Dr Shamshirsaz).
Shayan MostafaeiDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (Dr. Mostafaei).
Vincenzo BerghellaDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA (Dr. Berghella).
Yinka OyeleseMaternal Fetal Care Center, Division of Maternal Fetal Medicine and Surgery, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA (Dr. Zargarzadeh, Dr. Javinani, Dr. Qaderi, Dr. Oyelese, and Dr Shamshirsaz).
Alireza A ShamshirsazMaternal Fetal Care Center, Division of Maternal Fetal Medicine and Surgery, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA (Dr. Zargarzadeh, Dr. Javinani, Dr. Qaderi, Dr. Oyelese, and Dr Shamshirsaz).
Harvard University · USBoston Children's Hospital · USKermanshah University of Medical Sciences · IRKarolinska Institutet · SEThomas Jefferson University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: The incidence of preterm delivery is much higher in twin pregnancies than in singletons and even higher if a short cervical length is detected in the second trimester. Studies are contradictory regarding the efficacy of a cervical pessary to decrease preterm birth in twin pregnancies and short cervical length. To conduct a systematic review and meta-analysis investigating the efficacy of cervical pessary in prolonging gestation, preventing preterm birth, and reducing adverse neonatal outcomes in twin pregnancies with an asymptomatic short cervix. Data sources: PubMed, Scopus, Web of Science, and ClinicalTrials.org were searched for randomized controlled trials from inception to June 2023. Study eligibility criteria: In this study, randomized controlled trials comparing the cervical pessary to expectant management in the pregnant population with twin gestations and asymptomatic short cervix were included. Methods: The Cochrane risk-of-bias-2 tool for randomized controlled trials was used for the evaluation of the risk of bias in included studies. A meta-analysis was performed by calculating risk ratio and mean difference with their 95% confidence interval using the random effects model or fixed effect model on the basis of heterogeneity and accounting for potential covariates among the included randomized controlled trials. Results: A total of 6 randomized controlled trials were included in the analysis. Cervical pessary did not significantly increase the gestational age at delivery in twin pregnancies with asymptomatic patients (mean difference, 0.36 weeks [-0.27 to 0.99]; Conclusion: The use of cervical pessary in twin pregnancies with asymptomatic short cervix does not seem to be effective in increasing the gestational age at delivery, preventing preterm birth, or reducing adverse neonatal outcomes. This indicates that alternative interventions should be sought for the management of this patient population.

Indexed as

cervical pessaryextension of pregnancymeta-analysisneonatal outcomepreterm birth

Identifiers

PMID38655568
PMCPMC11036094
OpenAlexW4393343099

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.