Comparing Prophylactic Vaginal Progesterone & Cervical Cerclage In Preventing Preterm Birth: A Systematic Review

Abstract

Preterm birth complicates at-risk singleton pregnancies, and this is associated with a poor prognosis for pregnant mothers. When comparing cervical cerclage to vaginal progesterone, the rationale is clear, but its effectiveness remains a mystery.It is the goal of this systematic review to shed further light on this well-known conundrum. To find research on preventive vaginal progesterone usage vs cervical cerclage, PubMed, PubMed Central, Medline, Science Direct, and Google Scholar were searched. There were three randomized control trials, three systematic reviews and meta-analyses, two cohort studies, and two conventional reviews. It was determined that both strategies for managing preterm delivery were equally effective in terms of preterm birth prevention when applied to pregnant women. We found that vaginal progesterone had less side effects than cervical cerclage, but it has no influence on a woman's ability to function and does not improve her life expectancy. The systematic reviews and randomized controlled studies unequivocally confirmed these findings. Cervical cerclage was shown to be more risky than preventive vaginal progesterone in a comprehensive study. However, prophylactic application of cervical cerclage still remains a superior treatment modality if serial transvaginal ultrasound scans are pointing towards cervical shortening. Therefore, more research is required to understand this relationship to identify populations at risk.