Evidence map›Paper›PMID 40665107›Full record

SynthesisReproductive sciences (Thousand Oaks, Calif.)2025

Cervical Pessary Versus Vaginal Progesterone to Prevent Preterm Birth in Women with a Singleton Pregnancy and a Short Cervix: A Systematic Review and Meta-Analysis.

Ahmed Abu-Zaid, Saeed Baradwan, Bandr Hafedh, Afaf Tawfiq, Ghaidaa Farouk Hakeem, Alya Alkaff, Mohamed Abuzaid, Afnan Baradwan, Lolwa Almonayea, Shahad Alfadhli and 2 more

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Reproductive sciences (Thousand Oaks, Calif.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

12 authors.

Ahmed Abu-ZaidDepartment of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. aabuzaid@live.com.ORCID 0000-0003-2286-2181
Saeed BaradwanDepartment of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Bandr HafedhDepartment of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Afaf TawfiqDepartment of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Ghaidaa Farouk HakeemDepartment of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Alya AlkaffDepartment of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Mohamed AbuzaidDepartment of Obstetrics and Gynecology, Al Birk General Hospital, Al Birk, Saudi Arabia.
Afnan BaradwanDepartment of Obstetrics and Gynecology, Al Salama Hospital, Jeddah, Saudi Arabia.
Lolwa AlmonayeaObstetrics and Gynecology, Kuwait Institute for Medical Specializations, Kuwait City, Kuwait.
Shahad AlfadhliObstetrics and Gynecology, Kuwait Institute for Medical Specializations, Kuwait City, Kuwait.
Hessa AlqaedObstetrics and Gynecology, Kuwait Institute for Medical Specializations, Kuwait City, Kuwait.
Osama AlomarDepartment of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Vaginal progesterone (VP) is the recommended intervention for preventing preterm birth (PTB) in women with short cervix and singleton pregnancy. However, cervical pessary (CP) has been proposed as a simpler alternative. This study compares the efficacy and safety of both interventions. A systematic review and meta-analysis included randomized controlled trials (RCTs) from PubMed, CENTRAL, Scopus, Google Scholar, and Web of Science (up to November 2024). Based on heterogeneity, fixed- or random-effects models were used to analyze dichotomous outcomes as risk ratios (RR) and continuous outcomes as mean differences (MD), both with 95% confidence intervals (CI). Five RCTs with 1,427 patients were analyzed. No significant differences were found between CP and VP in PTB before 37 weeks (RR: 1.08, 95% CI: 0.87, 1.34), 34 weeks (RR: 1.08, 95% CI: 0.80, 1.44), or 28 weeks (RR: 1.42, 95% CI: 0.86, 2.33), time from randomization to delivery (MD: -0.13 h, 95% CI: -6.08, 5.82), maternal infection (RR: 0.98, 95% CI: 0.74, 1.30), neonatal/fetal mortality (RR: 1.19, 95% CI: 0.69, 2.06), neonatal sepsis (RR: 0.73, 95% CI: 0.36, 1.50), intraventicular hemorrhage (IVH; RR: 1.02, 95% CI: 0.23, 4.42), or necrotizing enterocolitis (NEC; RR: 3.36, 95% CI: 0.93, 12.22). However, CP significantly increased vaginal bleeding (RR: 2.79, 95% CI: 1.35, 5.77, p = 0.01). CP showed no clinical benefit in prolonging pregnancy, reducing PTB rates, or improving maternal or neonatal outcomes compared to VP. CP was associated with an increased risk of vaginal bleeding. However, these findings should be interpreted cautiously due to limited data.

Indexed as

Cervix UteriPessariesPremature BirthProgesteroneProgestinsAdministration, IntravaginalFemaleHumansPregnancyRandomized Controlled Trials as TopicProgesteroneProgestinsCervical pessaryMeta-analysisPreterm birthVaginal bleedingVaginal progesterone

Identifiers

PMID40665107

What OpenQuestion holds

Textmetadata
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.