PREGNANT Short Cervix Trial
Primary Purpose
Preterm Delivery, Short Cervix, Short Uterine Cervical Length
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
progesterone
placebo
Sponsored by

About this trial
This is an interventional prevention trial for Preterm Delivery focused on measuring Preterm, Cervix
Eligibility Criteria
Inclusion Criteria:
- The subject has a short cervical length by transvaginal ultrasound (TVU) defined as 10-20mm. In cases of "dynamic cervix", the shortest observed/documented cervical length by TVU is to be used as the cervical length for inclusion purposes.
- Singleton gestation.
- The pregnancy has an estimated gestational age between 19 0/7 weeks and 23 6/7 weeks.
- Maternal age between 15 (or local age of majority/emancipation) and 45 years of age at the time of screening. An alternative age range can be accepted according to the standards and applicable regulations of the study centers.
- The subject speaks either English or a common local language.
- The subject has voluntarily signed the Informed Consent Form and associated forms after having the contents explained, and all her questions are answered to her satisfaction and understanding.
- In the opinion of the investigator, the subject is able to understand the study and is able to give informed consent, as well as participate in it and adhere to study procedures.
Exclusion Criteria:
- The subject has a cervical length <10 or >20mm.
- The subject has a multifetal gestation.
- The subject has or is scheduled to have a cervical cerclage prior to randomization. According to ACOG Practice Bulletin Number 48 (November 2003), cerclage can be considered in a subject with a history of 3 or more unexplained midtrimester pregnancy losses or preterm deliveries.228,229
- Subjects diagnosed to have acute cervical insufficiency with bulging membranes passing the external os.
- The subject has a previous history of an adverse reaction to progesterone or any component present in Prochieve® 8% vaginal gel.
- The subject has been treated with a progestogen within the previous 4 weeks.
- The subject is currently being treated for a seizure disorder, has an unstable psychiatric disorder, is taking antihypertensive therapy for chronic hypertension at the time of enrollment, has a history of congestive heart failure or chronic renal failure, or has uncontrolled diabetes mellitus (known end-organ dysfunction secondary to vascular disease).
- The subject has active thrombophlebitis or a thromboembolic disorder, or a history of hormone-associated thrombophlebitis or thromboembolic disorders.
- The subject has active liver dysfunction or disease.
- The subject has known or suspected malignancy of the breast or genital organs.
- The subject is currently participating in another interventional study or has participated in an interventional drug study within one month prior to screening for this study.
- The subject's current pregnancy is complicated by a major fetal anomaly or known chromosomal abnormality.
- The subject has a uterine anatomic malformation (bicornuate uterus, septate uterus)
- The subject, in the judgment of the investigator, will be unable or unwilling to comply with study-related assessments and procedures.
- The subject currently has preterm rupture of membranes, vaginal bleeding, known or suspected amnionitis, or signs or symptoms of preterm labor at the time of enrollment.
- The subject is HIV positive with a CD4 count of <350 cells/mm3 and is receiving more than one (1) medication to prevent the transfer of AIDS to the fetus.
- Complete placenta previa.
Sites / Locations
- University of South Alabama Dept. of OB/GYN
- St. Joseph's Hospital and Med Ctr Women's Care Center
- UCI Medical Center
- Harbor-UCLA Medical Center
- University of Miami Leonard Miller School of Medicine Department of Obstetrics and Gynecology
- Kapi'olani Medical Center for Women and Children
- Perinatal Center of Iowa
- University of Kansas Medical Center
- Perinatal Diagnostic Center
- Johns Hopkins Community Physicians
- Caritas St. Elizabeth's Medical Center
- Perinatology Research Branch Hutzel Women's Hospital
- Henry Ford Healthcare System
- Spectrum Health Research Department
- St. Joseph Mercy-Oakland
- Washington University School of Medicine, Dept. of OB/GYN
- St. Louis University Health Sciences Center
- Cooper University Hospital
- Albert Einstein Hospital
- Winthrop University Hosital
- Lyndhurst Clinical Research
- UPHS Pennsylvania Hospital
- Thomas Jefferson University Hospital OB/GYN / Maternal Fetal Medicine
- Regional Obstetrical Consultants, Chattanooga
- Regional Obstetrical Consultants, Knoxville
- Eastern Virginia Medical School
- Charleston Area Medical Center Clinical Trials Center
- 1st Clinical Hospital of the City of Minsk
- Public Health Services Establishment "Vitebsk City Clinical Hospital of First Aid"
- Escuela De Medicina, Pontificia Universidad Catolica De Chile
- Maternidad Hospital DR Sotero Del Rio
- Charles University & General Teaching Hospital
- BJ Medical College & Sassoon Hospital
- Sri Ramchandra Medical College and Research Institute
- Sheth L.G. Hospital
- MediCiti Institute of Medical Sciences
- Government Medical College
- Soroka University Medical Center
- Kaplan Medical Center
- Sheba Medical Center
- Azienda Ospedaliera di Padova Centro Prenatale Divisione di Ostetricia
- Limited Liability Company "American Health Clinic"
- Saint Petersburg State Healthcare Institution Maternity Hospital 17
- Steve Biko Academic Hospital Dept. of OB-GYN and Maternal Fetal Medicine
- Municipal health care establishment "City Maternity Clinical Hospital"
- Department of Obstetrics and Gynecology of Dnepropetrovsk State Medical Academy, Municipal establishment "City Maternity Hospital # 1"
- M. Gorky Donetsk National Medical University, Department of Obstetrics, Gynecology and Perinatology, Maternity Hospital of 6th Central City Clinical Hospital
- Municipal clinical hospital #1
- Antenatal Clinic # 1, Central Polyclinics of Pechersk District
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Active Comparator
Arm Label
Placebo
Prochieve
Arm Description
placebo vaginal gel
Progesterone 8% Vaginal Gel
Outcomes
Primary Outcome Measures
Number of Participants With Birth <=32 6/7 Weeks Gestation.
Secondary Outcome Measures
Number of Infants With Neonatal Morbidities Such as Respiratory Distress Syndrome (RDS), Bronchopulmonary Dysplasia (BPD), Intraventricular Hemorrhage (IVH), Proven Sepsis, and Necrotizing Enterocolitis (NEC)
Each infant is scored based on the 7 morbidity and mortality events above:
0= no morbidity event
1 morbidity event
2 morbidity events
3 or more morbidity events
mortality
Number of Subjects With Preterm Birth at ≤27 6/7, ≤34 6/7, and <36 6/7 Weeks Gestation.
Number of participants at <=27 6/7 , <=34 6/7, and <36 6/7.
Number of Neonates Who Died.
Number of Infants With a Birth Weight < 1500 Grams or < 2500 Grams
Assessment of birth weight < 1500 grams or < 2500 grams
Full Information
NCT ID
NCT00615550
First Posted
January 18, 2008
Last Updated
February 27, 2012
Sponsor
Juniper Pharmaceuticals, Inc.
Collaborators
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
1. Study Identification
Unique Protocol Identification Number
NCT00615550
Brief Title
PREGNANT Short Cervix Trial
Official Title
The Effect of Vaginal Progesterone Administration in the Prevention of Preterm Birth in Women With a Short Cervix [Vaginal Progesterone Bioadhesive Gel (Prochieve)® Extending Gestation A New Therapy for Short Cervix - Trial (PREGNANT Short Cervix - Trial)]
Study Type
Interventional
2. Study Status
Record Verification Date
February 2012
Overall Recruitment Status
Completed
Study Start Date
March 2008 (undefined)
Primary Completion Date
November 2010 (Actual)
Study Completion Date
November 2010 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Juniper Pharmaceuticals, Inc.
Collaborators
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this research study is to evaluate the usefulness of progesterone vaginal gel in decreasing the preterm birth rate in a population of pregnant women with short cervical length and at high risk for preterm birth.
Detailed Description
A Short uterine cervical length in the mid-trimester is the most powerful predictor of preterm birth.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Preterm Delivery, Short Cervix, Short Uterine Cervical Length
Keywords
Preterm, Cervix
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
465 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
placebo vaginal gel
Arm Title
Prochieve
Arm Type
Active Comparator
Arm Description
Progesterone 8% Vaginal Gel
Intervention Type
Drug
Intervention Name(s)
progesterone
Other Intervention Name(s)
Prochieve 8%
Intervention Description
8% vaginal gel, 1.125 Grams once daily, beginning at 19 0/7 to 23 6/7 weeks gestation through 36 6/7 weeks gestation
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
vaginal gel, 1.125 Grams once daily, beginning at 19 0/7 to 23 6/7 weeks gestation through 36 6/7 weeks gestation
Primary Outcome Measure Information:
Title
Number of Participants With Birth <=32 6/7 Weeks Gestation.
Time Frame
9 to 13 weeks
Secondary Outcome Measure Information:
Title
Number of Infants With Neonatal Morbidities Such as Respiratory Distress Syndrome (RDS), Bronchopulmonary Dysplasia (BPD), Intraventricular Hemorrhage (IVH), Proven Sepsis, and Necrotizing Enterocolitis (NEC)
Description
Each infant is scored based on the 7 morbidity and mortality events above:
0= no morbidity event
1 morbidity event
2 morbidity events
3 or more morbidity events
mortality
Time Frame
Delivery Hospitalization (1-212 days)
Title
Number of Subjects With Preterm Birth at ≤27 6/7, ≤34 6/7, and <36 6/7 Weeks Gestation.
Description
Number of participants at <=27 6/7 , <=34 6/7, and <36 6/7.
Time Frame
Gestational Age at Delivery
Title
Number of Neonates Who Died.
Time Frame
Delivery to 28 days
Title
Number of Infants With a Birth Weight < 1500 Grams or < 2500 Grams
Description
Assessment of birth weight < 1500 grams or < 2500 grams
Time Frame
date of delivery
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
15 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
The subject has a short cervical length by transvaginal ultrasound (TVU) defined as 10-20mm. In cases of "dynamic cervix", the shortest observed/documented cervical length by TVU is to be used as the cervical length for inclusion purposes.
Singleton gestation.
The pregnancy has an estimated gestational age between 19 0/7 weeks and 23 6/7 weeks.
Maternal age between 15 (or local age of majority/emancipation) and 45 years of age at the time of screening. An alternative age range can be accepted according to the standards and applicable regulations of the study centers.
The subject speaks either English or a common local language.
The subject has voluntarily signed the Informed Consent Form and associated forms after having the contents explained, and all her questions are answered to her satisfaction and understanding.
In the opinion of the investigator, the subject is able to understand the study and is able to give informed consent, as well as participate in it and adhere to study procedures.
Exclusion Criteria:
The subject has a cervical length <10 or >20mm.
The subject has a multifetal gestation.
The subject has or is scheduled to have a cervical cerclage prior to randomization. According to ACOG Practice Bulletin Number 48 (November 2003), cerclage can be considered in a subject with a history of 3 or more unexplained midtrimester pregnancy losses or preterm deliveries.228,229
Subjects diagnosed to have acute cervical insufficiency with bulging membranes passing the external os.
The subject has a previous history of an adverse reaction to progesterone or any component present in Prochieve® 8% vaginal gel.
The subject has been treated with a progestogen within the previous 4 weeks.
The subject is currently being treated for a seizure disorder, has an unstable psychiatric disorder, is taking antihypertensive therapy for chronic hypertension at the time of enrollment, has a history of congestive heart failure or chronic renal failure, or has uncontrolled diabetes mellitus (known end-organ dysfunction secondary to vascular disease).
The subject has active thrombophlebitis or a thromboembolic disorder, or a history of hormone-associated thrombophlebitis or thromboembolic disorders.
The subject has active liver dysfunction or disease.
The subject has known or suspected malignancy of the breast or genital organs.
The subject is currently participating in another interventional study or has participated in an interventional drug study within one month prior to screening for this study.
The subject's current pregnancy is complicated by a major fetal anomaly or known chromosomal abnormality.
The subject has a uterine anatomic malformation (bicornuate uterus, septate uterus)
The subject, in the judgment of the investigator, will be unable or unwilling to comply with study-related assessments and procedures.
The subject currently has preterm rupture of membranes, vaginal bleeding, known or suspected amnionitis, or signs or symptoms of preterm labor at the time of enrollment.
The subject is HIV positive with a CD4 count of <350 cells/mm3 and is receiving more than one (1) medication to prevent the transfer of AIDS to the fetus.
Complete placenta previa.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
George W. Creasy, MD, FACOG
Organizational Affiliation
Columbia Laboratories, Inc.
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Roberto Romero, MD
Organizational Affiliation
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Sonia Hassan, MD
Organizational Affiliation
Wayne State University
Official's Role
Study Director
Facility Information:
Facility Name
University of South Alabama Dept. of OB/GYN
City
Mobile
State/Province
Alabama
ZIP/Postal Code
36604
Country
United States
Facility Name
St. Joseph's Hospital and Med Ctr Women's Care Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
UCI Medical Center
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Harbor-UCLA Medical Center
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
University of Miami Leonard Miller School of Medicine Department of Obstetrics and Gynecology
City
Miami
State/Province
Florida
ZIP/Postal Code
33101
Country
United States
Facility Name
Kapi'olani Medical Center for Women and Children
City
Honolulu
State/Province
Hawaii
ZIP/Postal Code
96826
Country
United States
Facility Name
Perinatal Center of Iowa
City
Des Moines
State/Province
Iowa
ZIP/Postal Code
50314
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Perinatal Diagnostic Center
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40503
Country
United States
Facility Name
Johns Hopkins Community Physicians
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21211
Country
United States
Facility Name
Caritas St. Elizabeth's Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02135
Country
United States
Facility Name
Perinatology Research Branch Hutzel Women's Hospital
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
Henry Ford Healthcare System
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Spectrum Health Research Department
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49503
Country
United States
Facility Name
St. Joseph Mercy-Oakland
City
Pontiac
State/Province
Michigan
ZIP/Postal Code
48341
Country
United States
Facility Name
Washington University School of Medicine, Dept. of OB/GYN
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
St. Louis University Health Sciences Center
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63117
Country
United States
Facility Name
Cooper University Hospital
City
Camden
State/Province
New Jersey
ZIP/Postal Code
08103
Country
United States
Facility Name
Albert Einstein Hospital
City
Bronx
State/Province
New York
ZIP/Postal Code
10461
Country
United States
Facility Name
Winthrop University Hosital
City
Mineola
State/Province
New York
ZIP/Postal Code
11501
Country
United States
Facility Name
Lyndhurst Clinical Research
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
UPHS Pennsylvania Hospital
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107-6130
Country
United States
Facility Name
Thomas Jefferson University Hospital OB/GYN / Maternal Fetal Medicine
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Regional Obstetrical Consultants, Chattanooga
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37403
Country
United States
Facility Name
Regional Obstetrical Consultants, Knoxville
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37920
Country
United States
Facility Name
Eastern Virginia Medical School
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States
Facility Name
Charleston Area Medical Center Clinical Trials Center
City
Charleston
State/Province
West Virginia
ZIP/Postal Code
25304
Country
United States
Facility Name
1st Clinical Hospital of the City of Minsk
City
Minsk
ZIP/Postal Code
22004
Country
Belarus
Facility Name
Public Health Services Establishment "Vitebsk City Clinical Hospital of First Aid"
City
Vitebsk
ZIP/Postal Code
210009
Country
Belarus
Facility Name
Escuela De Medicina, Pontificia Universidad Catolica De Chile
City
Santiago
Country
Chile
Facility Name
Maternidad Hospital DR Sotero Del Rio
City
Santiago
Country
Chile
Facility Name
Charles University & General Teaching Hospital
City
Prague
Country
Czech Republic
Facility Name
BJ Medical College & Sassoon Hospital
City
Pune
State/Province
Maharashtra
ZIP/Postal Code
411001
Country
India
Facility Name
Sri Ramchandra Medical College and Research Institute
City
Porur
State/Province
Tamil Nadu
ZIP/Postal Code
600003
Country
India
Facility Name
Sheth L.G. Hospital
City
Ahmedabad
ZIP/Postal Code
380008
Country
India
Facility Name
MediCiti Institute of Medical Sciences
City
Andhra Pradesh
ZIP/Postal Code
5014
Country
India
Facility Name
Government Medical College
City
Nagpur
ZIP/Postal Code
440003
Country
India
Facility Name
Soroka University Medical Center
City
Beer-Sheva
ZIP/Postal Code
84965
Country
Israel
Facility Name
Kaplan Medical Center
City
Rehovot
ZIP/Postal Code
76100
Country
Israel
Facility Name
Sheba Medical Center
City
Tel Hashomer
ZIP/Postal Code
58291
Country
Israel
Facility Name
Azienda Ospedaliera di Padova Centro Prenatale Divisione di Ostetricia
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
Limited Liability Company "American Health Clinic"
City
Saint Petersburg
ZIP/Postal Code
190000
Country
Russian Federation
Facility Name
Saint Petersburg State Healthcare Institution Maternity Hospital 17
City
Saint Petersburg
ZIP/Postal Code
192174
Country
Russian Federation
Facility Name
Steve Biko Academic Hospital Dept. of OB-GYN and Maternal Fetal Medicine
City
Pretoria
ZIP/Postal Code
0001
Country
South Africa
Facility Name
Municipal health care establishment "City Maternity Clinical Hospital"
City
Chernovtsy
ZIP/Postal Code
58001
Country
Ukraine
Facility Name
Department of Obstetrics and Gynecology of Dnepropetrovsk State Medical Academy, Municipal establishment "City Maternity Hospital # 1"
City
Dnepropetrovsk
ZIP/Postal Code
49000
Country
Ukraine
Facility Name
M. Gorky Donetsk National Medical University, Department of Obstetrics, Gynecology and Perinatology, Maternity Hospital of 6th Central City Clinical Hospital
City
Donetsk
ZIP/Postal Code
83062
Country
Ukraine
Facility Name
Municipal clinical hospital #1
City
Kiev
ZIP/Postal Code
2175
Country
Ukraine
Facility Name
Antenatal Clinic # 1, Central Polyclinics of Pechersk District
City
Kyiv
ZIP/Postal Code
01042
Country
Ukraine
12. IPD Sharing Statement
Citations:
PubMed Identifier
17899572
Citation
O'Brien JM, Adair CD, Lewis DF, Hall DR, Defranco EA, Fusey S, Soma-Pillay P, Porter K, How H, Schackis R, Eller D, Trivedi Y, Vanburen G, Khandelwal M, Trofatter K, Vidyadhari D, Vijayaraghavan J, Weeks J, Dattel B, Newton E, Chazotte C, Valenzuela G, Calda P, Bsharat M, Creasy GW. Progesterone vaginal gel for the reduction of recurrent preterm birth: primary results from a randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2007 Oct;30(5):687-96. doi: 10.1002/uog.5158.
Results Reference
background
PubMed Identifier
17899571
Citation
DeFranco EA, O'Brien JM, Adair CD, Lewis DF, Hall DR, Fusey S, Soma-Pillay P, Porter K, How H, Schakis R, Eller D, Trivedi Y, Vanburen G, Khandelwal M, Trofatter K, Vidyadhari D, Vijayaraghavan J, Weeks J, Dattel B, Newton E, Chazotte C, Valenzuela G, Calda P, Bsharat M, Creasy GW. Vaginal progesterone is associated with a decrease in risk for early preterm birth and improved neonatal outcome in women with a short cervix: a secondary analysis from a randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2007 Oct;30(5):697-705. doi: 10.1002/uog.5159.
Results Reference
background
PubMed Identifier
17671254
Citation
Fonseca EB, Celik E, Parra M, Singh M, Nicolaides KH; Fetal Medicine Foundation Second Trimester Screening Group. Progesterone and the risk of preterm birth among women with a short cervix. N Engl J Med. 2007 Aug 2;357(5):462-9. doi: 10.1056/NEJMoa067815.
Results Reference
background
PubMed Identifier
17899585
Citation
Romero R. Prevention of spontaneous preterm birth: the role of sonographic cervical length in identifying patients who may benefit from progesterone treatment. Ultrasound Obstet Gynecol. 2007 Oct;30(5):675-86. doi: 10.1002/uog.5174. No abstract available.
Results Reference
background
PubMed Identifier
21472815
Citation
Hassan SS, Romero R, Vidyadhari D, Fusey S, Baxter JK, Khandelwal M, Vijayaraghavan J, Trivedi Y, Soma-Pillay P, Sambarey P, Dayal A, Potapov V, O'Brien J, Astakhov V, Yuzko O, Kinzler W, Dattel B, Sehdev H, Mazheika L, Manchulenko D, Gervasi MT, Sullivan L, Conde-Agudelo A, Phillips JA, Creasy GW; PREGNANT Trial. Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2011 Jul;38(1):18-31. doi: 10.1002/uog.9017. Epub 2011 Jun 15.
Results Reference
result
PubMed Identifier
22284156
Citation
Romero R, Nicolaides K, Conde-Agudelo A, Tabor A, O'Brien JM, Cetingoz E, Da Fonseca E, Creasy GW, Klein K, Rode L, Soma-Pillay P, Fusey S, Cam C, Alfirevic Z, Hassan SS. Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data. Am J Obstet Gynecol. 2012 Feb;206(2):124.e1-19. doi: 10.1016/j.ajog.2011.12.003. Epub 2011 Dec 11.
Results Reference
result
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PREGNANT Short Cervix Trial
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