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.
Thornton J. Cervical Pessary and Spontaneous Preterm Birth. JAMA. 2018;319(17):1821. doi:10.1001/jama.2018.1474
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