Harefuah
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Preterm labor is defined as delivery before 37 weeks of gestation. Up to 17% of twin pregnancy are preterm. Arabin cervical pessary has been proven as preventing preterm labor in singleton pregnancies. The benefit of it in twin pregnancy is controversial. ⋯ Considering the conclusion in this research it seems that the combination of the mechanical effect of the pessary by embracing the cervix, keeping the cervical mucus, bending it in a way that the pressure is towards the anterior cervical wall together with the progestative effect which increases the estrogen/progesterone ratio, creating uterine quiescence and keeping the structural connective tissue of the cervix have an added benefit. It seems that the combined use of Arabin cervical pessary and vaginal progesterone in twin pregnancy with short cervical length have a synergic effect which may have a benefit in preventing preterm labor. The combination of cervical pessary and progesterone does not negatively affect twin pregnancy outcome and does not cause preterm birth.