The role of cervical pessary and progesterone therapy in the phenomenon of placenta previa migration.

Autor: Barinov SV; Federal State Budget Educational Institution of Higher Education 'Omsk State Medical University', Russian Ministry of Healthcare, Omsk, Russia., Shamina IV; Federal State Budget Educational Institution of Higher Education 'Omsk State Medical University', Russian Ministry of Healthcare, Omsk, Russia., Di Renzo GC; Department of Obstetrics and Gynecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy., Lazareva OV; Federal State Budget Educational Institution of Higher Education 'Omsk State Medical University', Russian Ministry of Healthcare, Omsk, Russia., Tirskaya YI; Federal State Budget Educational Institution of Higher Education 'Omsk State Medical University', Russian Ministry of Healthcare, Omsk, Russia., Medjannikova IV; Federal State Budget Educational Institution of Higher Education 'Omsk State Medical University', Russian Ministry of Healthcare, Omsk, Russia., Ledovskikh IO; Perinatal center, Budget Healthcare Omsk Region Institution 'Regional Clinical Hospital', Omsk, Russia., Klementyeva LL; OOO 'Alpha-EmBio', Omsk, Russia., Dudkova GV; Perinatal center, Budget Healthcare Omsk Region Institution 'Regional Clinical Hospital', Omsk, Russia.
Jazyk: angličtina
Zdroj: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2020 Mar; Vol. 33 (6), pp. 913-919. Date of Electronic Publication: 2019 Apr 09.
DOI: 10.1080/14767058.2018.1509068
Abstrakt: Objective: This study aimed to evaluate the effects of combined management of placenta previa with the Arabin cervical pessary and progesterone. Study design: In this randomized controlled study, we followed up 217 patients with placenta previa and high risk of preterm birth. The main group ( n  = 81) underwent combined management with the Arabin cervical pessary and progesterone; the control group ( n  = 136) received progesterone only. Placental migration was monitored using Doppler scanning from 24 weeks of pregnancy onwards. Results: Patients receiving the combination of the Arabin cervical pessary and progesterone had a three-fold reduced rate of bleeding during pregnancy compared with patients in the control group (11.3% versus 33.1%; p  = .006). Placental migration occurred 1.8 times more often in the pessary group (48.1% versus 26.4%; p  = .037), and preterm labor <34 weeks occurred 2.7 times less often compared with the control group ( p  = .031). The use of the Arabin cervical pessary caused a change in the anterior cervico-uterine angle by 7.4 degrees, and reduction in the arcuate artery RI at 32-33 weeks of pregnancy compared with the control group. Conclusions: The use of the Arabin cervical pessary combined with progesterone in patients with placenta previa significantly reduced the rate of preterm delivery <34 weeks and bleeding during pregnancy.
Databáze: MEDLINE
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