A Comparative Study of Cervical Cerclage and Vaginal Progesterone in the Prevention of Preterm Labour
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Abstract
Background: Preterm birth (PTB), defined as delivery occurring before 37 weeks of gestation, remains a major contributor to neonatal morbidity and mortality worldwide, particularly in high-risk pregnancies. The purpose of the study is to compare the efficacy of cervical cerclage and vaginal progesterone in preventing preterm labour in high-risk pregnancies.
Methods: This prospective comparative study was conducted at the Department of Fetomaternal Medicine, Bangladesh Medical University (BMU), and LAB AID Hospital, Dhaka, Bangladesh, from January 2024 to December 2025, including 50 high-risk pregnant women assigned to cervical cerclage (n=25) or vaginal progesterone (n=25). Baseline characteristics were recorded, and participants were followed until delivery to assess gestational age, latency, neonatal outcomes, and maternal complications. Data were analyzed using t-tests and chi-square/Fisher’s exact tests, with p < 0.05 considered significant.
Results: In 50 high-risk pregnancies, baseline characteristics were similar between cervical cerclage (n = 25) and vaginal progesterone (n = 25). Cerclage was associated with higher mean gestational age at delivery (36.2 ± 2.1 vs 34.8 ± 2.5 weeks; p = 0.043), longer latency (10.4 ± 3.1 vs 8.2 ± 3.6 weeks; p = 0.025), and higher mean birth weight (2.6 ± 0.4 vs 2.3 ± 0.5 kg; p = 0.027). Maternal complications were low and comparable, and neonatal outcomes generally favored cerclage.
Conclusion: Cervical cerclage modestly prolongs pregnancy and improves neonatal outcomes compared with vaginal progesterone in high-risk pregnancies, without increasing maternal complications.