A cheap medical device can dramatically reduce the number of premature births in some at-risk women, according to a team of doctors in Spain. Being born before 34 weeks of pregnancy is linked to a host of health problems.
The study showed that using a ‘cervical pessary’ reduced the rate in the at-risk group. Doctors said more studies were needed before the technique was used routinely.
The authors said 13 million babies were born prematurely every year.
In the trial, doctors were looking at women who had a cervix – part of the lower section of the uterus – which was shorter than 25mm. These pregnant women are thought to be at a higher risk of an early delivery.
The cervix was measured between 18 and 22 weeks into the pregnancy by an ultrasound scan. Of the 11,875 women who took part in the trial, 726 had a cervical length less than 25mm. Half of these women had a pessary, a small ring of silicone, inserted into their cervix.
In the group of women without the pessary, 27% of babies were born prematurely. The rate was six per cent among those fitted with a pessary.
Maria Goya, one of the researchers at the Vall d’Hebron Hospital, said: ‘Placement of a pessary is an affordable procedure, non-invasive, and easy to insert and remove as required.’
The study concluded the pessary was a ‘reliable alternative for prevention of preterm birth’ in a group of at-risk women.
Prof Steve Thornton of the University of Exeter, a spokesman for the Royal College of Obstetricians and Gynaecologists, said: ‘The difference in the two groups is pretty amazing.’
He said more research was needed to prove that it worked, and to find out if it could help other women at risk of a premature birth.
‘If this is borne out it could make a big difference,’ he added. BBC

Healthcare imaging specialist Barco has signed an agreement to acquire UK-based JAOtech, a leading manufacturer of patient entertainment and point-of-care terminals for hospitals. The acquisition fits within Barco’s long-term vision of increasing healthcare efficiency and its growth strategy of expanding into multiple healthcare segments. With the JAOtech terminals and associated software, Barco builds a strong position in the fast growing point of care (POC) segment in healthcare.

Patients who have had metal-on-metal hip replacements are no more likely to develop cancer in the first seven years after surgery than the general population, although a longer-term study is required, a study led by the University of Bristol claims.
A recent BMJ and BBC Newsnight investigation looked into the potentially high level of toxic metals from failing hip implants which may, in future, affect thousands of people around the world. The investigation also looked at why these hip replacements were allowed despite the risks being known and documented for decades. The BMJ has a large collection of articles about the safety of medical devices which can be found here.
This study, commissioned by the National joint Registry of England and Wales and carried out by authors from the Universities of Bristol and Exeter, looks at whether these concerns are valid. The registry contains records of over one million procedures from at least 97 per cent of orthopaedic units. Every year registry data and hospital episode statistics are linked up to check how patients who have had joint replacements are faring.
Ashley Blom, Professor of Orthopaedic Surgery in the School of Clinical Sciences at the University of Bristol, who led the team that undertook the study, said: ‘This research shows that there is no increased risk of cancer with metal-on-metal hip replacements in the first seven years after surgery. Although this is very reassuring, we do not know what are the long-term risks and thus further studies will be necessary in the future.’
In this study cancer rates in patients with metal-on-metal hip replacements were compared with both a group of patients who had other hip bearing surfaces implanted and the general population. Overall, 14 per cent (40,576) of registered patients had some type of metal-on-metal bearing surface: seven per cent (21,264) had a stemmed metal-on-metal prosthesis and seven per cent (19,312) had a resurfacing procedure. The researchers compared patients’ outcomes using mathematical modelling. The models included the age and sex of the patient as well as three measures of general health at the time of hip surgery (the American Society of Anaesthesiologists grade that scores the patient’s other serious illnesses, the number of distinct diagnostic codes recorded at time of surgery, and the number of NHS funded admissions to hospital in the previous five years). The authors do say, however, that comparison with the general population is not straightforward as hip replacement patients ‘tend to be healthier than others of the same gender and age group’.
Results show that the chance of a 60-year-old man with moderate health and a metal-on-metal stemmed hip replacement being diagnosed with cancer in the five years following surgery is 6.2 per cent, compared to 6.7 per cent chance with hip replacement using other bearing surfaces. For women, these figures were 4.0 per cent for metal-on-metal stemmed hip replacement and 4.4 per cent for other bearing surfaces. Further results show that the incidence of cancer diagnosis is low after hip replacement and lower than that predicted for the age and sex matched general population.
The authors hope that this study will help clinicians reassure patients that the ‘risk of cancer for hip replacement patients is relatively low’ with no evidence of an increase in cancer associated with metal-on-metal hips. They add though that this only shows results for up to seven years following surgery and the analysis of long-term data is required over the next few decades as some cancers take many years to develop. University of Bristol