Why do we need this research?
The cervix is a small canal that connects the vagina to the womb and plays an important role in stopping a baby being born too early. During pregnancy, the cervix changes shape as the baby grows. If it gets too short before the baby is due, there is a high risk that the baby will be born prematurely. This can lead to health problems for the baby and is a major cause of death shortly after birth.
If a woman’s cervix is less than 25mm long when she is under 24 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 ovaries 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.
What’s happening in this project?
SuPPoRT is a randomised controlled 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. This study is being carried out in many hospitals around the country and as of November 2020, nearly 350 women with a short cervix between 14 and 24 weeks of pregnancy have been randomly allocated to one of the three treatments.
As part of the SuPPoRT trial, samples of vaginal fluid and blood are also being taken before treatment. This will help our researchers to find out more about whether there are any underlying factors that influence how effective the treatments are.
Recruitment for this study is still ongoing. In total, the team hope that 400 women from around the country will take part.
What difference will this project make?
The SuPPoRT trial will find out which of the three methods is best at preventing premature labour in pregnant women with short cervixes. Ultimately, this will help doctors decide on the best treatment to reduce the chances of a woman giving birth too soon, giving them the best chance of having a healthy baby.
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