SuPPoRT: finding the best way to prevent preterm birth in women with short cervixes

Professor Andrew Shennan, Dr Rachel Tribe, Dr Natasha Hezelgrave, Helena Watson, Alexandra Ridout

Our researchers are comparing 3 different ways of treating a short cervix during pregnancy, to help stop babies being born too early.

Why do we need this research?

The cervix is important in stopping a baby being born too early. During pregnancy, the cervix changes shape as the baby grows inside the womb. If it gets too short before the baby is due, there is a high risk of the baby being born prematurely. This can lead to health problems for the baby, and is a major cause of death shortly after birth. We need to find the best way to prevent premature birth.

What’s happening in this project?

If a woman’s cervix is less than 25mm long when she is under 23 weeks pregnant, it is too short and should be treated. At the moment, there are three treatments that can be used if this happens.

Some women have a small surgical procedure called cervical cerclage. This involves an operation to put a stitch around the cervix to try and help it stay closed, keeping the baby inside the womb.

Others are given progesterone, a natural hormone that is usually made in the ovary during the menstrual cycle. This is given vaginally using a suppository.

Finally, some women use a cervical pessary: a silicon device put in by a doctor that sits around the cervix to help it stay closed. Putting a pessary in doesn’t need an operation.

To date, these three ways of stopping premature birth haven’t been compared. SuPPoRT is a randomised control trial that aims to find out which of these three methods is best at preventing premature birth, or if they are as effective as each other.

As of October 2019, the team have recruited nearly 300 women, and hope to recruit around 400 in total from across England.

Take part in the SuPPoRT trial

What difference will this project make?

There are three methods to prevent premature labour in pregnant women with short cervixes. The SuPPoRT trial will find out whether any of these methods is better than the others. Ultimately this will help doctors and women decide on the best treatment to reduce the chances of giving birth too soon, and give them the best chance of having a healthy baby.

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