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Conde-Agudelo, Agustin, MD, MPH; Romero, Roberto, MD, DMedSci; Nicolaides, Kypros, MD; Chaiworapongsa, Tinnakorn, MD; O'Brien, John M., MD; Cetingoz, Elcin, MD; da Fonseca, Eduardo, MD; Creasy, George, MD; Soma-Pillay, Priya, MD; Fusey, Shalini, MD; Cam, Cetin, MD; Alfirevic, Zarko, MD; Hassan, Sonia S., MD
American journal of obstetrics and gynecology, 2013, January 2013, 2013-Jan, 2013-01-00, 20130101, Letnik: 208, Številka: 1Journal Article
Objective No randomized controlled trial has compared vaginal progesterone and cervical cerclage directly for the prevention of preterm birth in women with a sonographic short cervix in the mid trimester, singleton gestation, and previous spontaneous preterm birth. We performed an indirect comparison of vaginal progesterone vs cerclage using placebo/no cerclage as the common comparator. Study Design Adjusted indirect metaanalysis of randomized controlled trials. Results Four studies that evaluated vaginal progesterone vs placebo (158 patients) and 5 studies that evaluated cerclage vs no cerclage (504 patients) were included. Both interventions were associated with a statistically significant reduction in the risk of preterm birth at <32 weeks of gestation and composite perinatal morbidity and mortality compared with placebo/no cerclage. Adjusted indirect metaanalyses did not show statistically significant differences between vaginal progesterone and cerclage in the reduction of preterm birth or adverse perinatal outcomes. Conclusion Based on state-of-the-art methods for indirect comparisons, either vaginal progesterone or cerclage are equally efficacious in the prevention of preterm birth in women with a sonographic short cervix in the mid trimester, singleton gestation, and previous preterm birth. Selection of the optimal treatment needs to consider adverse events, cost and patient/clinician preferences.
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Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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