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Effect of cervical pessary on pregnancy outcome in patients with twin pregnancies: a meta-analysis

Background Preterm birth is the main cause of child death under 5years
of age.The incidence of twin pregnancies is less than 2%, but the
incidence of preterm delivery is 50% and the risk of neonatal death is
5 times higher in twin pregnancies than in singleton
pregnancies.However,there is still no consensus on the effect of
cervical pessary on preventing preterm delivery, prolonging the
pregnancy cycle, and improving maternal and infant outcomes in patients
with twin pregnancies. Objectives To explore the effect of cervical
pessary on the pregnancy outcome of unselected twin pregnancy patients.
Search Strategy Up to July 2021,researchers searched PubMed, EMBASE,
COCHRANE, Web of Science, Wanfang, Weipu, and CNKI databases for
research. Selection Criteria Randomized controlled trials that compared
cervical pessary with standard care (no pessary) or alternative
interventions(conventional and standard treatment (e.g.Atoxiban therapy)
or vaginal progesterone) in patients with twin pregnancies. Data
Collection and Analysis Two authors（W-Y and M-D）independently
extracted information related to the study characteristics and test
results from each of the included literature, and used Revman 5.3 to
analyze the data. Conclusion The cervical pessary can extend the
gestational week of short-cervix twin pregnancy without clinical
symptoms, reduce the premature birth rate before 34 weeks of gestation,
improve pregnancy outcome, reduce neonatal mortality, reduce necrotizing
enterocolitis incidence, neonatal sepsis incidence, and improve neonatal
outcome.