Adjunctive Pessary Therapy after Emergency Cervical Cerclage for Cervical Insufficiency with Protruding Fetal Membranes in the Second Trimester of Pregnancy: A Novel Modification of Treatment.

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  • Additional Information
    • Source:
      Publisher: Hindawi Pub. Co Country of Publication: United States NLM ID: 101600173 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2314-6141 (Electronic) NLM ISO Abbreviation: Biomed Res Int Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York, NY : Hindawi Pub. Co.
    • Subject Terms:
      Pessaries*; Cerclage, Cervical/*methods ; Emergency Medical Services/*statistics & numerical data ; Uterine Cervical Incompetence/*surgery; Adult ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second ; Retrospective Studies ; Uterine Cervical Incompetence/epidemiology ; Young Adult
    • Abstract:
      Aim: To evaluate the effectiveness of adjunctive pessary therapy after emergency cervical cerclage (ECC) in improving perinatal outcome in cervical insufficiency with fetal membranes protruding into the vagina.
      Material and Methods: A retrospective analysis of patients treated at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between 2008 and 2013. The study group consisted of 15 women treated with ECC and a pessary and the control group consisted of 17 patients treated with cerclage only.
      Results: The mean gestational age at delivery was significantly higher in the study group (34.7 versus 29.7 weeks, p = 0.03). The period between cerclage insertion and delivery was significantly longer in the study group (82.9 versus 52.1 days, p = 0.045). The mean neonatal birthweight and neonatal "discharge alive" ratio were higher in the study group, although not statistically significant (2550 g versus 1883 g, p = 0.14, and 93.3% versus 70.5%, p = 0.18, resp.). NICU hospitalization rates were comparable (33.3% versus 35.3%, p = 0.9).
      Conclusions: Adjunctive pessary therapy allows delaying delivery in women treated with ECC due to cervical insufficiency with protruding fetal membranes. It also seems to improve neonatal outcome, although the differences are not statistically significant. Further prospective study is required to prove these findings.
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    • Publication Date:
      Date Created: 20150929 Date Completed: 20160802 Latest Revision: 20231111
    • Publication Date:
      20231111
    • Accession Number:
      PMC4564585
    • Accession Number:
      10.1155/2015/185371
    • Accession Number:
      26413506