Comparison of Cerclage and Pessary in Prevention of Preterm Birth in Twin Pregnancies

Background and Aim : The preterm labor has increased in multiple pregnancies over the past two decades.Preterm labor has led to increased in neonatal mortality rates, long-term morbidity, respiratory distress, andneonatal infections. The present study aimed at investigating the effect of Cerclage versus Pessary on thePrevention of preterm birth in twin pregnancies.Methods : The current prospective, randomized clinical trial was performed on Fifty women pregnant withtwins who visited in Taleghani Hospital in 2016-2018 were selected for this project. Their cervical lengthwas less than 30 millimeters in the 14 weeks of pregnancy. It was measured by transvaginal ultrasonography(TVS). The participants were randomly divided into two groups (n = 25). They separately underwentcervical pessary and cerclage. McDonald s procedure was performed in cerclage group from 14 to 27 weeks.The Suture material was Mersilene Ethicon 5-0 double-armed s14 needle. Ring hodge pessary was alsoinserted in the vagina of the subjects in the pessary group. All the patients were injected weekly 250mgintramuscular 17 alpha|_hydroxyprogesterone caproate from 16 to 36weeks. Collected data was analyzedusing SPSS v.18.Results : : There was a significant relationship between length of pregnancy and use of cervical pessaryand cerclage.Conclusion : : It is recommended to use cerclage in twin pregnancies to increase the length of pregnancy.

Keywords:

Cerclage , pessary , twin pregnancy