{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:24:55Z","timestamp":1777483495244,"version":"3.51.4"},"reference-count":24,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"12","license":[{"start":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T00:00:00Z","timestamp":1703289600000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective The aim of the present study is to compare the effectiveness of Arabin pessary and McDonald cervical cerclage on preterm delivery.<\/jats:p><jats:p>\n          Methods\u2003We conducted a retrospective analysis of data from patients who underwent either Arabin pessary or McDonald cerclage between January 1, 2019, and January 1, 2023. A total of 174 patients were included in the study, with 31 undergoing Arabin pessary and 143 receiving cervical cerclage using the McDonald technique in singleton pregnant women with cervical insufficiency, which applied between 14 and 22 gestational weeks. We included singleton pregnant women with normal morphology, and with normal combined test. The primary outcome was the impact of each method on preterm delivery (&lt; 34 gestational weeks).<\/jats:p><jats:p>\n          Results\u2003The weeks of cervical cerclage or pessary application were compatible with each other (p\u2009&lt;\u20090.680). The pessary group had a statistically significant longer time to delivery compared with the Cerclage group (cerclage group mean 30.8 c 7.1 standard deviation [SD] versus pessary group mean 35.1\u2009\u00b1\u20094.4 SD; p\u2009&lt;\u20090.002). A statistically significant difference was found between the pessary and cerclage groups in terms of delivery at\u2009&lt;\u200934 weeks (p\u2009=\u20090.002). In patients with cervical length between 25 and 15mm and\u2009&lt;\u200915mm, no significant difference was found between the pessary and cerclage groups in terms of delivery week (p\u2009&lt;\u20090.212; p\u2009&lt;\u20090.149). Regardless of the technique applied, no statistically significant difference was observed between cervical length and birth\u2009&lt;\u200934 weeks.<\/jats:p><jats:p>\n          Conclusion\u2003Our study found that pessary use for cervical insufficiency is statistically more effective than cervical cerclage surgery in preventing preterm births\u2009&lt;\u200934 weeks in singleton pregnancy.<\/jats:p>","DOI":"10.1055\/s-0043-1776033","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T23:30:32Z","timestamp":1703374232000},"page":"e764-e769","source":"Crossref","is-referenced-by-count":2,"title":["Arabin-pessary or McDonald Cerclage in Cervical Shortening?"],"prefix":"10.61622","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2999-9992","authenticated-orcid":false,"given":"Aytaj","family":"Jafarzade","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Koru Hospital Ankara, Ankara, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7478-6382","authenticated-orcid":false,"given":"Sveta","family":"Aghayeva","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Koru Hospital Ankara, Ankara, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2646-4412","authenticated-orcid":false,"given":"Tamer","family":"Mungan","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Koru Hospital Ankara, Ankara, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9886-703X","authenticated-orcid":false,"given":"Aydan","family":"Biri","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Koru Hospital Ankara, Ankara, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4004-0336","authenticated-orcid":false,"given":"Osman Ufuk","family":"Ekiz","sequence":"additional","affiliation":[{"name":"Statistic Department, Gazi University, Yenimahalle, Ankara, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"47794","published-online":{"date-parts":[[2023,12,23]]},"reference":[{"issue":"9606","key":"ref1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(08)60074-4","article-title":"Epidemiology and causes of preterm birth","volume":"371","author":"R L Goldenberg","year":"2008","journal-title":"Lancet"},{"issue":"12","key":"ref2","first-page":"CD014508","article-title":"Cervical pessary for preventing preterm birth in singleton pregnancies","volume":"12","author":"H Abdel-Aleem","year":"2022","journal-title":"Cochrane Database Syst 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Son","year":"2016","journal-title":"Am J Obstet Gynecol"},{"issue":"07","key":"ref6","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1111\/1471-0528.14392","article-title":"Universal cervical length screening for singleton pregnancies with no history of preterm delivery, or the inverse of the Pareto principle","volume":"124","author":"P Rozenberg","year":"2017","journal-title":"BJOG"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/01.AOG.0000443276.68274.cc","article-title":"ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency","volume":"123","author":"American College of Obstetricians and Gynecologists","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/GRF.0000000000000190","article-title":"Cerclage: shirodkar, McDonald, and modifications","volume":"59","author":"S L Wood","year":"2016","journal-title":"Clin Obstet Gynecol"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1515\/JPM.2003.017","article-title":"Is treatment with vaginal pessaries an option in patients with a sonographically detected short cervix?","volume":"31","author":"B Arabin","year":"2003","journal-title":"J Perinat Med"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1002\/uog.12507","article-title":"Arabin cervical pessary in women at high risk of preterm birth: a magnetic resonance imaging observational follow-up study","volume":"42","author":"M M Cannie","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"08","key":"ref11","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.7863\/ultra.16.08054","article-title":"Cervical Pessary for Preventing Preterm Birth in Singleton Pregnancies With Short Cervical Length: A Systematic Review and Meta-analysis","volume":"36","author":"G Saccone","year":"2017","journal-title":"J Ultrasound Med"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1002\/uog.5333","article-title":"Cervical length and obstetric history predict spontaneous preterm birth: development and validation of a model to provide individualized risk assessment","volume":"31","author":"E Celik","year":"2008","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s00404-005-0082-2","article-title":"Noninvasive cerclage for the management of cervical incompetence: a prospective study","volume":"273","author":"G Acharya","year":"2006","journal-title":"Arch Gynecol Obstet"},{"issue":"9828","key":"ref14","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1016\/S0140-6736(12)60030-0","article-title":"Cervical pessary in pregnant women with a short cervix (PECEP): an open-label randomised controlled trial","volume":"379","author":"M Goya","year":"2012","journal-title":"Lancet"},{"issue":"04","key":"ref15","first-page":"283","article-title":"Cerclage pessary for preventing preterm birth in women with a singleton pregnancy and a short cervix at 20 to 24 weeks: a randomized controlled trial","volume":"30","author":"S Y Hui","year":"2013","journal-title":"Am J Perinatol"},{"key":"ref16","first-page":"576723","article-title":"Cervical pessaries for the prevention of preterm birth: a systematic review","volume":"2013","author":"S M Liem","year":"2013","journal-title":"Obstet Gynecol Int"},{"issue":"20","key":"ref17","doi-asserted-by":"crossref","first-page":"3439","DOI":"10.1080\/14767058.2019.1573894","article-title":"Arabin cervical pessary with vaginal progesterone versus vaginal progesterone for preventing preterm delivery","volume":"33","author":"Y Melcer","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"S 01","key":"ref18","doi-asserted-by":"crossref","first-page":"S236","DOI":"10.1016\/j.ajog.2018.11.358","article-title":"Arabin cervical pessary with vaginal progesterone versus vaginal progesterone for preventing preterm delivery","volume":"220","author":"M Pekar-Zlotin","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"12","key":"ref19","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1111\/jog.13138","article-title":"Combined treatment with cervical pessary and vaginal progesterone for the prevention of preterm birth: A randomized clinical trial","volume":"42","author":"N Karbasian","year":"2016","journal-title":"J Obstet Gynaecol Res"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"375.e1","DOI":"10.1016\/j.ajog.2009.08.015","article-title":"Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length","volume":"201","author":"J Owen","year":"2009","journal-title":"Am J Obstet Gynecol"},{"issue":"11","key":"ref21","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1056\/NEJMoa1511014","article-title":"A Randomized Trial of a Cervical Pessary to Prevent Preterm Singleton Birth","volume":"374","author":"K H Nicolaides","year":"2016","journal-title":"N Engl J Med"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1186\/s12884-022-04584-4","article-title":"Progesterone, cervical cerclage or cervical pessary to prevent preterm birth: a decision-making analysis of international guidelines","volume":"22","author":"K Putora","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1002\/uog.12300","article-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","volume":"41","author":"Z Alfirevic","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"15","key":"ref24","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1080\/14767058.2019.1668923","article-title":"The impact of a short cervix and funneling on the outcome in singleton pregnancies treated with an Arabin-pessary or a McDonald cerclage","volume":"34","author":"N Mouzakiti","year":"2021","journal-title":"J Matern Fetal Neonatal Med"}],"container-title":["Revista Brasileira de Ginecologia e Obstetr\u00edcia \/ RBGO Gynecology and 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