Study of the Effectiveness of Cervical Cerclage Versus Progesterone in Preterm Labor. A Comparative Clinical Trial

Ismail, Anwer Ezzat; Abdallah, Walid; Thabit, Hudi Alshareef; Diab, Wafaa Mohamed

doi:10.21608/zumj.2023.231989.2862

Study of the Effectiveness of Cervical Cerclage Versus Progesterone in Preterm Labor. A Comparative Clinical Trial

Document Type : Original Article

Authors

¹ Obstetrics &amp; Gynecology faculty of medicine Zagazig unversity Egypt

² Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt

³ MBCCH, Faculty of Medicine, Benghazi- University -Libya

⁴ Department, Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt

10.21608/zumj.2023.231989.2862

Abstract

Background:

Patients with a singleton pregnancy, a history of spontaneous preterm delivery, and a short cervix may benefit from preterm birth prevention strategies that involve vaginal progesterone treatment as well as the placement of a cervical cerclage.

Aim: comparing the efficacy of using both vaginal and intramuscular progesterone versus cervical cerclage for prevention of the preterm birth among females with previous history of preterm birth.

Methods:

One hundred and twenty pregnant females with an increased risk of preterm labor (assessed by a previous preterm birth (PTB) or transvaginal ultrasound (TVUS) findings of a shortened cervix which is less than 25 mm participated in this randomized controlled study at the Obstetrics and Gynecological Department of Zagazig University Hospital. Group A: 62 pregnant women had progesterone therapy in the form of vaginal suppositories 400mg twice per day and intramuscular long-acting progesterone per week at 13 weeks to 37 weeks gestational age. Group B: (Cervical Cerclage group) 58 pregnant women who had Cervical Cerclage at 13 weeks gestation without progesterone.

Results:

Cervical length is significantly increased in the cerclage group from 1.877+.41 cm to 2.18+.31 cm with P value <0.001 after doing the cerclage. When compared to the cervical cerclage, progesterone use yielded similar effects with non-statistically significant differences in terms of method of delivery, pregnancy fate, and neonatal outcomes.

Conclusion:

The progesterone is successful as cervical cerclage in preventing preterm labor but its usage could be better in clinical as it's noninvasive method and economic

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