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

What this Trial Is About

Researchers are studying the prevention of preterm birth in women with twin pregnancies who have a short cervix measuring 30 mm or less. The trial aims to compare the effects of combining cervical cerclage with vaginal progesterone versus using vaginal progesterone alone. This condition is important because twin pregnancies carry a higher risk of early birth, which can lead to serious health issues for newborns, including complications affecting vital organs and long-term developmental problems. Participants are randomly assigned to one of two groups: one group will receive a cervical cerclage procedure plus vaginal progesterone, while the other group will receive vaginal progesterone alone. The cerclage involves placing a suture around the cervix before 24 weeks of pregnancy under spinal anesthesia. Vaginal progesterone is given twice daily until 37 weeks of pregnancy or delivery. The procedure is performed by trained obstetricians, and participants record their progesterone use in a diary to track adherence. During the study, participants will have follow-up visits every one to two weeks until delivery. These visits include routine antenatal care, cervical length measurement, and checks for any complications or side effects. Researchers will monitor outcomes such as the timing of birth before 28 weeks, other preterm birth milestones, maternal and neonatal health, and hospital costs. Data will also be collected from medical records if delivery occurs outside the study centers. The trial follows participants from randomization until delivery and postpartum periods as specified.

Cerclage Plus Progesterone vs Progesterone Alone in Twin Short Cervix