Atraumatic forceps-guided insertion of the cervical pessary: a new technique to prevent preterm birth in women with asymptomatic cervical shortening.

Autor:	Dereli ML; Department of Obstetrics and Gynecology, Division of Perinatology, Ministry of Health Denizli State Hospital, Denizli, Türkiye., Obut M; Department of Obstetrics and Gynecology, Division of Perinatology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye., Özkan S; Department of Obstetrics and Gynecology, Division of Perinatology, Ministry of Health Ankara Etlik City Hospital, Ankara, Türkiye., Sucu S; Department of Obstetrics and Gynecology, Division of Perinatology, Ministry of Health Ankara Etlik City Hospital, Ankara, Türkiye., Fıratlıgil FB; Department of Obstetrics and Gynecology, Division of Perinatology, Ministry of Health Ankara Etlik City Hospital, Ankara, Türkiye., Kurt D; Department of Obstetrics and Gynecology, Ministry of Health Ankara Etlik City Hospital, Ankara, Türkiye., Kurt A; Department of Obstetrics and Gynecology, Ministry of Health Ankara Etlik City Hospital, Ankara, Türkiye., Sarsmaz K; Department of Obstetrics and Gynecology, Division of Perinatology, Manisa Celal Bayar University Hospital, Manisa, Türkiye., Tolunay HE; Department of Obstetrics and Gynecology, Division of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Türkiye., Çağlar AT; Department of Obstetrics and Gynecology, Division of Perinatology, Ministry of Health Ankara Etlik City Hospital, Ankara, Türkiye., Üstün YE; Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Türkiye.
Jazyk:	angličtina
Zdroj:	Journal of perinatal medicine [J Perinat Med] 2024 Dec 16. Date of Electronic Publication: 2024 Dec 16.
DOI:	10.1515/jpm-2024-0444
Abstrakt:	Objectives: As previous studies on the use of a cervical pessary to prevent preterm birth (PTB) have produced conflicting results, we aimed to investigate the feasibility, acceptability and safety of a new technique for inserting a cervical pessary and compare it with the traditional technique in patients at high risk of PTB. Methods: Women at high risk of PTB treated with a cervical pessary between January 2018 and January 2021 were retrospectively evaluated. After applying exclusion criteria, a total of 68 eligible patients were identified and retrospectively analyzed. The primary outcome was spontaneous PTB before 34 weeks' gestation (WG). Results: Of 68 participants, 39 were treated with the traditional method (group 1) and 29 with the new insertion technique (group 2). The rate of spontaneous PTB before 34 WG was significantly lower in group 2 (p=0.020). Birthweight, APGAR scores and satisfaction with the method were significantly higher, while PTB before 37 WG was significantly lower in group 2 (p=0.043, 0.010, 0.009, 0.042 and 0.014, respectively). There were no significant differences in the rates of perinatal death (12.8 vs. 3.4 % in groups 1 and 2, respectively; p=0.229). The concomitant use of vaginal progesterone was required more frequently in group 1. According to the binary regression analysis, the new insertion technique resulted in a 5.42 and 3.97-fold protection against PTB before 34 and 37 WG. Conclusions: Our preliminary results show that our new technique of pessary insertion is more effective than the traditional method in preventing PTB due to cervical shortening. (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)
Databáze:	MEDLINE
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