Introduction

The majority of babies born prematurely survive and develop normally. However, babies born before 34 weeks have a higher chance of dying soon after birth or becoming disabled than babies born at term. In singleton pregnancies the chance that a woman will go into labour and deliver before 34 weeks is about 1%

An effective method of identifying women at high risk of premature delivery is the measurement of cervical length by ultrasound at 20-25 weeks of gestation. Randomized studies in women with a short cervix have shown that the risk of premature delivery can be reduced by them taking progesterone. However, even after treatment with progesterone the risk for premature delivery remains high.

There is some evidence that in women with a short cervix the use of a vaginal pessary reduces the chances of premature birth but the evidence is weak and therefore this issue needs further investigation.

The Fetal Medicine Foundation is conducting a multicentre study in several countries to determine if in women with a short cervix the insertion of a vaginal pessary reduces the chances of premature birth.

Vaginal silicone pessary