20 February 2019

A study to try to resolve uncertainty around whether the Arabin pessary reduces spontaneous preterm birth in twins and improves outcomes for babies has come to an end.

Hundreds of families from Twins Trust took park in the STOPPIT2 study and we would like to say a huge thank you because your support helped answer an important question about the use of pessaries.

7,000 women with a twin pregnancy were asked if they would have an ultrasound scan to measure the length of their cervix (neck of the womb) and 2,228 women agreed.

Women who had the scan and then found to have short cervical length measurement (less or equal to 35mm) were eligible to join the treatment phase of the study.

Of these 503 women, 250 received the Arabin pessary and 253 standard treatment.

Even though the study showed the pessary did not reduce the risk of preterm birth or reduce risk of complications for the baby, it helps researchers know where to focus their efforts now.

Cervical length scanning test does not rule out the risk of a preterm birth but if a very short cervical length (less than 20mm) is identified, the measurement may be useful for predicting an increased preterm birth risk.

Interestingly, women who took part reported better outcomes for their babies and themselves than women with similar pregnancies who did not participate.  It is not clear why this is the case although other studies have noted extra one-to-one care might explain this.

These findings will help healthcare professionals plan how best to care for women who are pregnant with twins and who have a short cervix. Information obtained from participants in the study may help inform on the future healthcare of other patients. 

We were very pleased to be able to help find participants for the STOPPIT 2 study, but did you know Twins Trusts funds other research in this field?

Last year we co-funded, with the BMFMS, research by the University of Sheffield into ‘Exploring Novel Techniques for the Prediction of Spontaneous Preterm Birth in Multiple Pregnancies’ and ‘Quantitative fetal fibronectin, cervical length and vaginal microbiota for the prediction of preterm birth in twin pregnancies undergoing fetal laser surgery’ by University College London (UCL).

We recently co-funded two studies with the BMFMS around preterm birth – Examining the myometrial transcriptome in twin pregnancy, which is being carried out at the Liverpool Women’s Hospital and is coming to a conclusion shortly, and the ENCIRCLE: Emergency Cerclage in Twin Pregnancies at Imminent Risk of Preterm Birth study.

The ENCIRCLE study, conducted by researchers from St George’s Hospital, focuses on whether a stitch in the cervix (cerclage) may provide extra support. There is no good quality convincing evidence to suggest which of these has better outcomes for mum and babies in twin pregnancies.

The trial aims to determine whether securing the weakened cervix with a cerclage will help to prolong the pregnancy and prevent early delivery. Babies who are born early experience multiple complications including lung, brain and learning difficulties.