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Comment & Response
May 1, 2018

Cervical Pessary and Spontaneous Preterm Birth

Author Affiliations
  • 1Department of Obstetrics and Gynaecology, University of Nottingham, Nottingham, England
JAMA. 2018;319(17):1821. doi:10.1001/jama.2018.1474

To the Editor Dr Saccone and colleagues1 conducted a randomized clinical trial on the effect of a cervical pessary in women with singleton pregnancies and short cervical length and found that a pessary compared with no pessary resulted in a lower rate of spontaneous preterm birth. The authors achieved exactly their trial registry–planned sample size of 300, with 100% follow-up and 100% adherence to treatment allocation in both groups. The adherence seems implausible, as my patients commonly request removal for discomfort or other reasons.