{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T15:53:47Z","timestamp":1773762827231,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,1,17]],"date-time":"2013-01-17T00:00:00Z","timestamp":1358380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the outcome of pregnancy in cohorts of women with singleton pregnancy and history of preterm birth and sonographic short cervix managed with different treatment protocols, namely cerclage, vaginal progesterone or cervical pessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a comparison of three management protocols for women with singleton pregnancy and a high risk of preterm birth because of a prior spontaneous preterm birth before 34\u2009weeks and a shortened cervical length detected by transvaginal ultrasound. The study included 142 women who were initially treated with cerclage (<jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>), 59 with vaginal progesterone (<jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>) and 42 with cervical pessary (Spain). Perinatal outcomes were compared between the three cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no statistically significant differences in perinatal losses, neonatal morbidity and preterm births among the three groups, apart from a higher rate of preterm birth before 34 weeks' gestation after treatment with vaginal progesterone in comparison with treatment with cervical pessary (32% <jats:italic>vs<\/jats:italic> 12%; relative risk (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>)\u2009=\u20092.70; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.10\u20136.67). When only the subgroups of women with cervical length &lt;\u200925\u2009mm, irrespective of gestational age, were compared, the difference between these two cohorts was not statistically significant (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\u2009=\u20092.21; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.83\u20135.89).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cerclage, vaginal progesterone and pessary appear to have similar effectiveness as management strategies in women with singleton pregnancy, previous spontaneous preterm birth and short cervix. Direct randomized comparisons of these strategies, or combinations thereof, are needed to determine optimal management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12300","type":"journal-article","created":{"date-parts":[[2012,9,18]],"date-time":"2012-09-18T14:49:08Z","timestamp":1347979748000},"page":"146-151","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":93,"title":["Vaginal progesterone, cerclage or cervical pessary for preventing preterm birth in asymptomatic singleton pregnant women with a history of preterm birth and a sonographic short cervix"],"prefix":"10.1002","volume":"41","author":[{"given":"Z.","family":"Alfirevic","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health, Institute of Translational Medicine University of Liverpool  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Owen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maternal\u2010Fetal Medicine Division University of Alabama  Birmingham AL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Carreras Moratonas","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron Universitat Autonoma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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M.","family":"Szychowski","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama  Birmingham AL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Goya","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron Universitat Autonoma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,1,17]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60074-4"},{"key":"e_1_2_5_3_1","unstructured":"U.S. Food and Drug Admistration.FDA statement Makena.http:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm249025.htm[Accessed 27 December2011]."},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.05.022"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5333"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.11.1340"},{"issue":"124","key":"e_1_2_5_8_1","first-page":"1","article-title":"Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and meta\u2010analysis of individual patient data","volume":"206","author":"Romero R","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.10.881"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008991.pub2"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820ca847"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2003.017"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60030-0"},{"issue":"375","key":"e_1_2_5_14_1","first-page":"1","article-title":"Multicenter randomized trial of cerclage for preterm birth prevention in high risk women with shortened midtrimester cervical length","volume":"201","author":"Owen J","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.11.1340"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6332"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2001.00369.x"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000262.pub3"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004454.pub2"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-79"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.12300","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.12300","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.12300","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.12300","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T18:10:00Z","timestamp":1692987000000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.12300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1,17]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,2]]}},"alternative-id":["10.1002\/uog.12300"],"URL":"https:\/\/doi.org\/10.1002\/uog.12300","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,17]]},"assertion":[{"value":"2012-08-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-01-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}