Definition:

Preterm birth also known as premature birth, is the birth of a baby at fewer than 37 weeks'
gestational age. These babies are known as preemies or premies.

Symptoms of preterm labor include uterine contractions which occur more often than every ten
minutes or the leaking of fluid from the vagina.

Application in medicine.
Preterm birth is responsible for more than 70% of all neonatal and infant deaths. In addition,
the risk of cerebral palsy among children born preterm is 10 times as high as that among those
born at term. The risks of perinatal death and illness are inversely related to gestational age at
delivery.

An alternative approach for the prevention of preterm birth is the transvaginal placement of a
silicone pessary around the cervix; this device is thought to support the cervix and change its
direction toward the sacrum, thereby reducing the direct pressure from the uterine contents on
the cervical canal.

Pros and Cons

Pros
There were no significant between-group
differences in the prespecified secondary
outcomes of perinatal death, adverse
neonatal event, and neonatal special
care.
Cons
Pathogens in the vaginal swabs, most
commonly Candida albicans, group B
streptococcus, or Gardnerella vaginalis,
were found in a similar percentage of
participants in the pessary group and the
control group both at recruitment.

Issues applied in Ecuador

At the Misereor Basic Hospital in Gualaquiza, the silicone ring or cervical pessary has been
successfully used to prevent premature birth. Preterm labor is the cause of more than half of
newborn deaths; but the placement of this device "is a method with scientific evidence that
reduces this loss by 75 percent", explained the specialist José Luis Quezada

Conclusion
Preterm birth is the leading cause of neonatal and infant death and of disability among survivors.
It is unclear if a pessary inserted around the cervix reduces the risk of preterm singleton birth.
For that reason We have to keep investigating about it to better the technique.

The randomized trial showed that among girls and women with singleton pregnancies who had
a short cervix, a cervical pessary did not result in a lower rate of spontaneous early preterm
delivery than the rate with expectant management.