{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T14:36:51Z","timestamp":1793111811472,"version":"4.5.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To compare the effectiveness of cervical pessary to vaginal progesterone for the prevention of preterm birth in women with twin pregnancies and short cervix.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This randomized controlled trial was conducted at My Duc Hospital, Vietnam. Asymptomatic women with twin pregnancies and cervical length less than 38 mm were randomized to Arabin pessary or vaginal progesterone (400 mg once a day) group. The primary outcome was preterm birth at less than 34 weeks of gestation. Secondary outcomes were adverse maternal and perinatal complications. We planned a subgroup analysis according to quartile of cervical length. Analysis was conducted on an intention-to-treat basis. We estimated that the primary outcome would occur in 28.4% of women treated with progesterone. Thus a total sample size of 290 women divided equally into two groups was required to detect a 14% absolute risk difference in the primary outcome between the two groups (power 80%, alpha-error 5%, 10% loss to follow-up).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Between March 2016 and June 2017, we randomized 300 women, 150 women in each group. Preterm birth at less than 34 weeks of gestation occurred in 24 (16%) women in the pessary group and 33 (22%) women in the progesterone group (relative risk [RR] 0.73, 95% CI 0.46\u20131.18). The use of pessary significantly reduced the composite of poor perinatal outcomes (19% vs 27%; RR 0.70, 95% CI 0.43\u20130.93). In women with cervical length of 28 mm or less (25th percentile), pessary significantly reduced the preterm birth rate at less than 34 weeks of gestation from 46% (16\/35) to 21% (10\/47) (RR 0.47, 95% CI 0.24\u20130.90) and significantly improved the composite of poor perinatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Cervical pessary and 400 mg vaginal progesterone resulted in similar rates of preterm birth at less than 34 weeks of gestation in women with twin pregnancies and cervical length less than 38 mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL TRIAL REGISTRATION:<\/jats:title>\n                    <jats:p>ClinicalTrials.gov, NCT02623881.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/aog.0000000000003136","type":"journal-article","created":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T16:24:50Z","timestamp":1549988690000},"page":"459-467","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":48,"title":["Pessary Compared With Vaginal Progesterone for the Prevention of Preterm Birth in Women With Twin Pregnancies and Cervical Length Less Than 38 mm"],"prefix":"10.1097","volume":"133","author":[{"given":"Vinh Q.","family":"Dang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linh K.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toan D.","family":"Pham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen T. N.","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khang N.","family":"Vu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh T. N.","family":"Phan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh Q.","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cam H.","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan N.","family":"Vuong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben W.","family":"Mol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20261027","first-page":"1","article-title":"Births: final data for 2013","volume":"64","author":"Martin","year":"2015","journal-title":"Natl Vital Stat Rep"},{"key":"R2-20261027","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1056\/NEJM199602293340904","article-title":"The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network","volume":"334","author":"Iams","year":"1996","journal-title":"N Engl J Med"},{"key":"R3-20261027","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1046\/j.1469-0705.1998.12050312.x","article-title":"Cervical length at 23 weeks of gestation: prediction of spontaneous preterm delivery","volume":"12","author":"Heath","year":"1998","journal-title":"Ultrasound Obstet Gynecol"},{"key":"R4-20261027","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.ajog.2005.11.001","article-title":"Maternal characteristics and cervical length in the prediction of spontaneous early preterm delivery in twins","volume":"194","author":"To","year":"2006","journal-title":"Am J Obstet Gynecol"},{"key":"R5-20261027","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1111\/1471-0528.13575","article-title":"The effect of gestational age and cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies: an individual patient level meta-analysis","volume":"123","author":"Kindinger","year":"2016","journal-title":"BJOG"},{"key":"R6-20261027","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.1471-0528.2012.03448.x","article-title":"Increased doses of vaginal progesterone for the prevention of preterm birth in twin pregnancies: a randomised controlled double-blind multicentre trial","volume":"120","author":"Serra","year":"2013","journal-title":"BJOG"},{"key":"R7-20261027","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/1471-0528.13032","article-title":"Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis","volume":"122","author":"Schuit","year":"2015","journal-title":"BJOG"},{"key":"R8-20261027","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ajog.2015.11.012","article-title":"Cervical pessary to prevent preterm birth in women with twin gestation and sonographic short cervix: a multicenter randomized controlled trial (PECEP-Twins)","volume":"214","author":"Goya","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"R9-20261027","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/S0140-6736(13)61408-7","article-title":"Cervical pessaries for prevention of preterm birth in women with a multiple pregnancy (ProTWIN): a multicentre, open-label randomised controlled trial","volume":"382","author":"Liem","year":"2013","journal-title":"Lancet"},{"key":"R10-20261027","doi-asserted-by":"crossref","first-page":"3.e1","DOI":"10.1016\/j.ajog.2015.08.051","article-title":"Cervical pessary placement for prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial","volume":"214","author":"Nicolaides","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"R11-20261027","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1002\/uog.17430","article-title":"Prevention of preterm birth with pessary in twins (PoPPT): a randomized controlled trial","volume":"49","author":"Berghella","year":"2017","journal-title":"Ultrasound Obstet Gynecol"},{"key":"R12-20261027","doi-asserted-by":"crossref","first-page":"2918","DOI":"10.1080\/14767058.2016.1268595","article-title":"Cervical pessary for preventing preterm birth in twin pregnancies with short cervical length: a systematic review and meta-analysis","volume":"30","author":"Saccone","year":"2017","journal-title":"J Matern Fetal Neonatal Med"},{"key":"R13-20261027","doi-asserted-by":"crossref","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ"},{"key":"R14-20261027","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1002\/uog.12540","article-title":"Cervical pessaries for prevention of spontaneous preterm birth: past, present and future","volume":"42","author":"Arabin","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"key":"R15-20261027","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/j.1471-0528.2004.00059.x","article-title":"How should randomised trials including multiple pregnancies be analysed?","volume":"111","author":"Gates","year":"2004","journal-title":"BJOG"},{"key":"R16-20261027","article-title":"PROMPT: prospective meta-analysis for pessary trials","author":"Saade","year":"2018"},{"key":"R17-20261027","doi-asserted-by":"crossref","first-page":"e0122341","DOI":"10.1371\/journal.pone.0122341","article-title":"STOPPIT baby follow-up study: the effect of prophylactic progesterone in twin pregnancy on childhood outcome","volume":"10","author":"McNamara","year":"2015","journal-title":"PLoS One"},{"key":"R18-20261027","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1002\/uog.15948","article-title":"Long-term effects of prenatal progesterone exposure: neurophysiological development and hospital admissions in twins up to 8 years of age","volume":"48","author":"Vedel","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"key":"R19-20261027","doi-asserted-by":"crossref","first-page":"2106","DOI":"10.1016\/S0140-6736(16)00350-0","article-title":"Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial","volume":"387","author":"Norman","year":"2016","journal-title":"Lancet"},{"key":"R20-20261027","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1002\/uog.19029","article-title":"Pessary for prevention of preterm birth in twin pregnancy with short cervix: 3-year follow-up study","volume":"51","author":"van't Hooft","year":"2018","journal-title":"Ultrasound Obstet Gynecol"}],"updated-by":[{"DOI":"10.1097\/aog.0000000000006043","type":"retraction","label":"Retraction","source":"retraction-watch","updated":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"record-id":"67061"}],"container-title":["Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00006250-201903000-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T14:03:23Z","timestamp":1793109803000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006250-201903000-00008"}},"subtitle":["A Randomized Controlled Trial"],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1097\/aog.0000000000003136","relation":{},"ISSN":["0029-7844","1873-233X"],"issn-type":[{"value":"0029-7844","type":"print"},{"value":"1873-233X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]},"assertion":[{"value":"2018-10-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}