Is treatment with vaginal pessaries an option in patients with a sonographically detected short cervix?
-
B. Arabin
Abstract
Objective: The purpose was to determine the effect of vaginal pessaries in patients at risk for spontaneous preterm birth (SPB).
Study Design: Transvaginal sonography (TVS) was longitudinally performed to measure cervical length (CL) in 258 singleton at risk for SPB and 282 twin pregnancies. Pairs with or without treatment were matched for gestational age and the CL at examination.
Results: In 4 singleton and 7 twin pregnancies the CL was < 15 mm before 24 weeks, the mean interval between pessary insertion and delivery was 13+2 and 12+5 weeks respectively. For the matched control analysis, 12 pairs with singleton and 23 pairs with twin pregnancies were compared. For singleton pregnancies, the mean interval between TVS and delivery was 99 (70–134) days in the treatment and 67 (2–130) days in the control group (p = 0.0184), the mean gestational age at delivery was 38 (36+6–41) and 33+4 (26–38) weeks respectively (p = 0.02). For twin pregnancies, the interval was 85 (43–129) days in the treatment and 67 (21–100) days in the control group (p = 0.001), gestational age at delivery was 35+6 (33–37+4) and 33+2 (24+4–37+2) respectively (p = 0.02). Within singleton pregnancies with pessary, there was no SPB < 36 weeks compared to 6/12 cases in the control group (p < 0.001). Within twin pregnancies, the rates were 8/23 cases with SPB < 36 weeks but none < 32 weeks, compared to 12/23 cases with SPB < 36 weeks and 7/23 cases < 32 weeks in the control group (p < 0.001).
Conclusions: Insertion of a vaginal pessary may be a cost-effective preventive treatment in patients at risk for SPB. Prospective controlled trials are needed.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Mode of conception, placental morphology and perinatal outcome of twin gestations
- The effects of birth weight discordance and prematurity on twin neonatal outcome
- Esophageal atresia and tracheoesophageal fistula: the impact of prenatal suspicion on neonatal outcome in a tertiary care center
- Microbial invasion of the amniotic cavity at birth is associated with adverse short-term outcome of preterm infants
- Is treatment with vaginal pessaries an option in patients with a sonographically detected short cervix?
- The effects of intramuscular administration of corticosteroids on the induction of parturition
- Perinatal significance of diagnosing glucose intolerance during pregnancy with portable glucose meter
- Biovar diversity of Ureaplasma urealyticum in amniotic fluid: distribution, intrauterine inflammatory response and pregnancy outcomes
- Comparative study on the expression of cytokine – receptor genes in normal and preeclamptic human placentas using DNA microarrays
- Chorioangioma – new insights into a well-known problem I. Results of a clinical and morphological study of 136 cases
- Chorioangiomas – new insights into a well-known problem II. An immuno-histochemical investigation of 136 cases
- Impaired CD14-dependent and independent response of polymorphonuclear leukocytes in preterm infants
- The left portal vein is the watershed of the fetal venous system
- Congress Calendar
Articles in the same Issue
- Mode of conception, placental morphology and perinatal outcome of twin gestations
- The effects of birth weight discordance and prematurity on twin neonatal outcome
- Esophageal atresia and tracheoesophageal fistula: the impact of prenatal suspicion on neonatal outcome in a tertiary care center
- Microbial invasion of the amniotic cavity at birth is associated with adverse short-term outcome of preterm infants
- Is treatment with vaginal pessaries an option in patients with a sonographically detected short cervix?
- The effects of intramuscular administration of corticosteroids on the induction of parturition
- Perinatal significance of diagnosing glucose intolerance during pregnancy with portable glucose meter
- Biovar diversity of Ureaplasma urealyticum in amniotic fluid: distribution, intrauterine inflammatory response and pregnancy outcomes
- Comparative study on the expression of cytokine – receptor genes in normal and preeclamptic human placentas using DNA microarrays
- Chorioangioma – new insights into a well-known problem I. Results of a clinical and morphological study of 136 cases
- Chorioangiomas – new insights into a well-known problem II. An immuno-histochemical investigation of 136 cases
- Impaired CD14-dependent and independent response of polymorphonuclear leukocytes in preterm infants
- The left portal vein is the watershed of the fetal venous system
- Congress Calendar
