*Prevention of Preterm Birth*

In recent years, the use of vaginal pessary has been returned to the forefront. The vaginal pessary that is used is Arabin pessary [40]. A multifactorial research in Spain proved that, in women with cervical length <25 mm in 18–22 weeks of pregnancy, the use of pessary decreased premature birth in 34 weeks of gestation by 88% and also decreased neonate complications [41]. On the other hand, a new study proved that the preventive usage of vaginal pessary in twin pregnancies does not improve the perinatal result [42]. We have to wait also for the result of other studies to prove or not its usage, and whether the use of vaginal pessaries in women with decreased length of the cervix is helpful. When they do not want or they cannot undergo cervical cerclage, particularly for women with decreased cervical length after 25 weeks of gestation, cervical cerclage is not helpful. We found no negative association between early preterm labor and pessary and so we can confirm the effectiveness of this conservative procedure. No complications were noticed [43,44]. In cases where a cerclage was performed, the contribution of the surgical procedure was not positive to prolong the pregnancy duration, although no serious side effects occurred. However, the necessity of cerclage was not confirmed in our participants, similar to several previously published papers [45–48].
