Vaginal Progesterone Stays the Benchmark for Short Cervix Without Prior Preterm Birth
This Bayesian network meta-analysis ranks progestogen, cerclage, and pessary strategies head to head for the large group of women with a short cervix and no spontaneous preterm birth history, a gap earlier pairwise reviews left open.
📅 Journal publication: 2026(online Oct 12, 2026)·Last updated: Oct 16, 2026
Vaginal progesterone beats combination therapies for preterm birth prevention.
Preterm birth prevention in specific pregnancies is crucial for improving neonatal outcomes. Vaginal progesterone monotherapy showed high efficacy in reducing preterm birth before 34 weeks (RR 0.56) and had excellent maternal safety. The study supports vaginal progesterone as a standard for preventing preterm birth in specific populations, with combination treatments requiring further research. Vaginal progesterone remains the best option for preventing preterm birth in high-risk pregnancies with a short cervix.
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Authors:Wu H, Yu L, Zhang J, Goya M, Otsuki K, Cruz-Melguizo S, Fu X
Citation:Wu H, Yu L, Zhang J, et al. Progestogens, cervical cerclage, and cervical pessary for preventing preterm birth in asymptomatic singleton pregnancies with a sonographic short cervix and no previous history of spontaneous preterm birth: systematic review and bayesian network meta-analysis. BMJ medicine. 2026;5(1):e003010. doi:10.1136/bmjmed-2026-003010
Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.
Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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