EP17.79: Does cervical cerclage plus progesterone work better than only vaginal progesterone in women with very short cervix

To compare the efficacy of two different treatment regimens: cervical stitch and progesterone versus progesterone alone in women identified with very short cervix (<15mm). It was a retrospective cohort study which included all women with singleton pregnancies attending routine appointments for scans at 11-14 weeks, 18-24 weeks, 24-28 weeks. Women with multiple pregnancies, fetal chromosomal abnormalities, structural defects, uterine anomalies, prior preterm birth, second trimester losses were excluded. The options of cerclage and progesterone versus progesterone alone were offered based on obstetrician's choice and patients' preferences. The primary outcome measure was gestational age at delivery and secondary outcome measures were birthweight, need for emergency Caesarean section, NICU admission, birth outcomes and PPROM rates. 55.8% of the total number of patients (n = 86) were diagnosed on midtrimester screening at 18-24 weeks, 4% at 11-14 weeks, the rest at 24-28 weeks. Those in the cerclage group (n = 48) were older and were diagnosed at an earlier gestational age than those in the progesterone only group (n = 38). There was no statistically significant difference between the 2 groups in terms of gestational age at delivery. The secondary outcome measures were also similar in both. Vaginal progesterone used alone is therefore as effective as cerclage plus progesterone in those with very short cervix (<15mm). This study also shows that both these types of treatment had been effective in preventing preterm birth and thus a routine midtrimester cervical screening is of paramount importance in all pregnant women. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.