Startseite Safety and efficacy of the cervical pessary combined with vaginal progesterone for the prevention of spontaneous preterm birth
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Safety and efficacy of the cervical pessary combined with vaginal progesterone for the prevention of spontaneous preterm birth

  • Georgios Daskalakis EMAIL logo , Dimitrios Zacharakis , Marianna Theodora ORCID logo , Panagiotis Antsaklis , Nikolaos Papantoniou , Dimitris Loutradis und Aris Antsaklis
Veröffentlicht/Copyright: 21. Oktober 2017

Abstract

Introduction:

The aim of this study was to evaluate the safety and efficacy of the combined treatment of cervical pessary and endovaginal progesterone for the prevention of spontaneous preterm birth (SPB) in women with a short cervical length (CL) between 20 and 24 weeks of gestation.

Materials and methods:

This is a prospective study of women with a singleton pregnancy and a sonographically detected mid-trimester CL ≤25 mm. The primary outcome measure was spontaneous delivery before 34 weeks (238 days) of gestation.

Results:

The study sample consisted of 90 women with a mean CL of 14.2 mm (SD=6.5 mm). Of the women, 34.4% had at least one risk factor for SPB; 7.8% delivered preterm before 34 weeks of gestation, and 25.6%, before 37 weeks. Neonatal death occurred in two (2.2%) cases due to respiratory distress syndrome. Lower body mass index values, history of preterm delivery and number of second trimester miscarriages were independently associated with delivery before 34 weeks.

Conclusion:

The combination of vaginal progesterone and cervical pessary for the prevention of SPB in women with a short cervix is safe and well tolerated. This therapy was associated with pregnancy prolongation, reduced prematurity rate and a low rate of perinatal complications.

  1. Author’s statement

  2. Conflict of interest: Authors state no conflict of interest.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

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Received: 2017-1-7
Accepted: 2017-9-18
Published Online: 2017-10-21
Published in Print: 2018-7-26

©2018 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. A transformative icon for modern perinatology
  4. Highlight: Preterm Labor
  5. Editorial
  6. What’s new in preterm birth prediction and prevention?
  7. Review articles
  8. Pulmo uterinus: a history of ideas on fetal respiration
  9. Mid-trimester preterm premature rupture of membranes (PPROM): etiology, diagnosis, classification, international recommendations of treatment options and outcome
  10. Highlight articles
  11. A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18–24 weeks is associated with a higher prevalence of spontaneous preterm delivery
  12. Association between genital mycoplasmas, acute chorioamnionitis and fetal pneumonia in spontaneous abortions
  13. Methylation differences reveal heterogeneity in preterm pathophysiology: results from bipartite network analyses
  14. Understanding fetal factors that contribute to preterm birth: Sjögren-Larsson syndrome as a model
  15. Safety and efficacy of the cervical pessary combined with vaginal progesterone for the prevention of spontaneous preterm birth
  16. Risk of preterm birth by maternal age at first and second pregnancy and race/ethnicity
  17. Infant mortality and causes of death by birth weight for gestational age in non-malformed singleton infants: a 2002–2012 population-based study
  18. Perinatal outcomes after previable preterm premature rupture of membranes before 24 weeks of gestation
  19. Letter to the Editor
  20. Fundal pressure: risk factors in uterine rupture. The issue of liability: complication or malpractice?
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