Cervical pessary for short cervix in high risk pregnant women: 5 years experience in a single centre

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
Jelena IvandicZ Alfirevic

Abstract

To describe single centre clinical experience with cervical pessary used for high risk pregnant women who also had short cervix. We have focused on the techniques to optimise efficacy and minimise risk of complications and side effects related to pessary insertion, removal and pregnancy management. This is an audit from specialist preterm birth prevention clinic in Liverpool Women's Hospital, United Kingdom for the period between January 2013 and December 2017. We also conducted postal survey in November 2015 to evaluate women's experience with vaginal pessary. Out of 235 women who were treated for short cervix, 129 (55%) had cervical pessary as a first line treatment. Overall, 50% of treated women reached term. 17 women (13%) needed additional treatment, 9 women had pessary reinserted (7%) and 53 (41%) had pessary removed before 36 weeks, mainly due to ruptured membranes. Significant vaginal discharge and pelvic discomfort were reported by 14 and 7% women, respectively. Eighty-nine% of treated women would recommend the pessary treatment to others. Whilst the cervical pessary continues to be evaluated in clinical trials, our experience suggests that pessary is quite easy to insert and remove and is well tolerated by the women.

References

May 16, 2003·Journal of Perinatal Medicine·Birgit ArabinJim van Eyck
Mar 12, 2009·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·L J SalomonY Ville
Apr 6, 2012·Lancet·Maria GoyaUNKNOWN Pesario Cervical para Evitar Prematuridad (PECEP) Trial Group
Aug 9, 2012·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·Yuen Ha TingTak Yeung Leung
Sep 20, 2012·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·Z AlfirevicM Goya
Jun 19, 2013·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·B Arabin, Z Alfirevic
Mar 18, 2016·The New England Journal of Medicine·Kypros H NicolaidesJesus Rodriguez Calvo
Oct 9, 2016·The Journal of Obstetrics and Gynaecology Research·Jaroslaw KalinkaAdam Bitner
May 10, 2017·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·G C Di RenzoG H A Visser
Sep 25, 2017·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·L DugoffJ Ludmir
Dec 21, 2017·JAMA : the Journal of the American Medical Association·Gabriele SacconeUNKNOWN Italian Preterm Birth Prevention (IPP) Working Group
Feb 21, 2018·BJOG : an International Journal of Obstetrics and Gynaecology·N MedleyZ Alfirevic

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Citations

May 20, 2020·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Lisa DawesKatie Groom
May 22, 2020·British Journal of Clinical Pharmacology·Wael Y KhawagiRichard N Keers

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