Primary and secondary outcomes
The primary outcome was GA at delivery. The main secondary outcomes were as follows: maternal outcomes of pregnancy latency, rate of sPTB at <28, <30, <32 and <34 weeks; and neonatal outcomes. The primary and secondary outcomes were also evaluated in the subgroups of women with cervical dilation of <3cm and ≥ 3cm to evaluate the efficacy of combined McDonald-Shirodkar technique in less or more severe cases.