{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:44:07Z","timestamp":1788353047253,"version":"build-2803163510"},"reference-count":17,"publisher":"BMJ","issue":"12","funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The STOPPIT-2 study aims to determine the clinical utility of the Arabin cervical pessary in preventing preterm birth in women with a twin pregnancy and a short cervix, about which there is current uncertainty. STOPPIT-2 will resolve uncertainty around effectiveness for women with a twin pregnancy and a cervical length of 35\u2009mm or less, define adverse effects, ascertain acceptability and estimate National Health Service costs and savings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>STOPPIT-2 is a pragmatic multicentre open-label randomised controlled trial. Consenting women with twin pregnancy will have an transvaginal ultrasound scan of their cervical length performed between 18+0\u2009and 20+6 weeks\u2019 gestation by an accredited practitioner: women with a cervical length of \u226435\u2009mm will be eligible for inclusion in the treatment phase of the study. The intervention by the insertion of the Arabin cervical pessary will be compared with standard treatment (no pessary).<\/jats:p>\n                    <jats:p>The primary outcomes are (obstetric) spontaneous onset of labour for the mother leading to delivery before 34 weeks\u2019 gestation and (neonatal) a composite of specific adverse outcomes or death occurring up to the end of the first 4\u2009weeks after the estimated date of delivery to either or both babies.<\/jats:p>\n                    <jats:p>We plan to recruit 500 women in the treatment phase of the study. Assuming a treatment effect of 0.6, and background rates of 35% and 18%, respectively, for each of the primary outcomes, our study has 85% power to detect a difference between the intervention and the control groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>Data will be analysed on the intention-to-treat principle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics<\/jats:title>\n                    <jats:p>STOPPIT-2 was approved by the South East Scotland Ethics Committee 02 on 29 August 2014, reference number 14\/SS\/1031 IRAS ID 159610.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Dissemination<\/jats:title>\n                    <jats:p>Peer reviewed journals, presentations at national and international scientific meetings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT98835694\" ext-link-type=\"clintrialgov\">NCT98835694<\/jats:ext-link>\n                      and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT02235181\" ext-link-type=\"clintrialgov\">NCT02235181<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-026430","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T10:11:33Z","timestamp":1775297493000},"page":"e026430","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Open randomised trial of the (Arabin) pessary to prevent preterm birth in twin pregnancy with health economics and acceptability: STOPPIT-2\u2014a study protocol"],"prefix":"10.1136","volume":"8","clinical-trial-number":[{"clinical-trial-number":"nct98835694","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02235181","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03418311","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03058536","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02708264","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02350231","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct01334489","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6031-6953","authenticated-orcid":false,"given":"Jane E","family":"Norman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Norrie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"Maclennan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Whyte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Cunningham Burley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel B E","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Shennan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen C","family":"Robson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Thornton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D","family":"Kilby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Marlow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4308-856X","authenticated-orcid":false,"given":"Sarah J","family":"Stock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip R","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Denton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,12,6]]},"reference":[{"key":"2023040221274499000_8.12.e026430.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60947-8"},{"key":"2023040221274499000_8.12.e026430.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000168435.17200.53"},{"key":"2023040221274499000_8.12.e026430.3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-1827"},{"key":"2023040221274499000_8.12.e026430.4","doi-asserted-by":"crossref","unstructured":"Chang HH , Larson J , Blencowe H , et al . Preventing preterm births: analysis of trends and potential reductions with interventions in 39 countries with very high human development index. Lancet 2013;381.doi:10.1016\/S0140-6736(12)61856-X","DOI":"10.1016\/S0140-6736(12)61856-X"},{"key":"2023040221274499000_8.12.e026430.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61956-4"},{"key":"2023040221274499000_8.12.e026430.6","doi-asserted-by":"crossref","unstructured":"Abdel-Aleem H , Shaaban OM , Abdel-Aleem MA . Cervical pessary for preventing preterm birth. Cochrane Database Syst Rev 2013;379:CD007873.doi:10.1002\/14651858.CD007873.pub3","DOI":"10.1002\/14651858.CD007873.pub3"},{"key":"2023040221274499000_8.12.e026430.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61408-7"},{"key":"2023040221274499000_8.12.e026430.8","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":"2023040221274499000_8.12.e026430.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.11.012"},{"key":"2023040221274499000_8.12.e026430.10","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":"2023040221274499000_8.12.e026430.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.11.001"},{"key":"2023040221274499000_8.12.e026430.12","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":"2023040221274499000_8.12.e026430.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.10.866"},{"key":"2023040221274499000_8.12.e026430.14","unstructured":"Curtis L . Costs of health and social care personal social services research unit: University of Kent, 2013."},{"key":"2023040221274499000_8.12.e026430.15","unstructured":"Department of Health NHS reference costs. 2011-2012 NHS Reference Costs, 2013."},{"key":"2023040221274499000_8.12.e026430.16","doi-asserted-by":"crossref","unstructured":"Mason J . Qualitative researching. London: Sage Publications Ltd, 2018.","DOI":"10.4135\/9781036234492"},{"key":"2023040221274499000_8.12.e026430.17","unstructured":"Silverman D . Doing qualitative research: a practical handbook. London: Sage publications Ltd, 2000."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-026430","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T10:11:33Z","timestamp":1775297493000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-026430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12]]},"references-count":17,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2018,12,6]]},"published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1136\/bmjopen-2018-026430"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-026430","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12]]}}}