This study aims to confirm whether the Arabin cervical pessary prevents preterm birth in women with a twin pregnancy and a short cervix (neck of the womb). Preterm birth is associated with increased risk of death and ill health for the baby, so if preterm birth could be prevented in twins this would be a very good thing. The Arabin cervical pessary is used to reduce preterm birth in women with a singleton pregnancy (one baby). A Dutch study has suggested that the cervical pessary might also prevent preterm birth in twins. Although the pessary did not work in all twins, it appeared to reduce preterm birth in those women with a twin pregnancy who had a short cervix. The study aims to resolve uncertainty around whether the Arabin pessary reduces spontaneous preterm birth in twins and improves outcomes for babies, and whether women find the treatment acceptable. It will also calculate the costs for the NHS. We will look at the proportion of babies who are born before 34 weeks and the complications that happen to babies, and we will compare these between the two groups.
The study is a multicentre evaluation of maternity care delivered through the Saving Babies’ Lives care bundle using both quantitative and qualitative methodologies. The study will be conducted in twenty NHS Hospital Trusts from six NHS Strategic Clinical Networks totalling approximately 100,000 births. It involves participation by both service users and care providers.
RAPID (Reliable Accurate Prenatal non-Invasive Diagnosis) is a five-year UK national programme funded by the National Institute for Health Research.
The aim of the research programme is to improve the quality of NHS prenatal diagnostic services by evaluating early non-invasive prenatal diagnosis (NIPD) based on cell-free fetal (cff) DNA and RNA in maternal plasma.