The Arabin pessary to prevent preterm birth in women with a twin pregnancy and a short cervix: the STOPPIT 2 RCT

Jane E Norman, John Norrie, Graeme Maclennan, David Cooper, Sonia Whyte, Sue Chowdhry, Sarah Cunningham-Burley, Aileen Neilson, Xue W Mei, Joel W S Smith, Andrew Shennan, Stephen C Robson, Steven Thornton, Mark Kilby, Neil Marlow, Sarah J E Stock, Philip Bennett, Jane Denton

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Women who are pregnant with twins have a much higher risk of going into labour early and having an early (preterm) birth than women who are pregnant with only one baby. For this reason, babies who are twins are much more likely to die or to have serious health complications in the first months of life. Although we know that women with twin pregnancy are at risk, there are no treatments that are recommended to prevent early births. Some studies have suggested that the Arabin pessary can help. The Arabin pessary is a silicone ring that fits around the cervix (neck of the womb). The pessary can be put in place in a clinic without any need for an anaesthetic. Some studies have suggested that the Arabin pessary helps and others have suggested that it does not. It appears to be most helpful when the cervix (neck of the womb) is already shortening. Shortening of the neck of the womb is a sign that early birth is even more likely. We asked women with twin pregnancy to take part in STOPPIT 2. Women who agreed had an ultrasound scan of the neck of the womb, which measured its length. Those with a short cervix were randomised to be offered the Arabin pessary (in addition to standard care) or standard care alone. This allocation was carried out ‘at random’ by a computer. We followed women up until the end of their pregnancy and collected information on the babies’ health after birth. We found that the Arabin pessary did not reduce the risk of an early birth; nor did it reduce the risk of health complications for the baby. We conclude that the Arabin pessary should not be used for this purpose.
Original languageEnglish
Pages (from-to)1-66
JournalHealth Technology Assessment
Volume25
Issue number44
DOIs
Publication statusPublished - 1 Jul 2021

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