COMPREHENSIVE APPROACH TO USING AN OBSTETRICAL PESSARY IN THE MANAGEMENT OF PREGNANT WOMEN AT HIGH RISK FOR PRETERM DELIVERY


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Abstract

Objective. To compare the efficiency of using a Dr. Arabin obstetric pessary and a circular cervical stitch in pregnant women at high risk for preterm delivery. Subjects and methods. A total of 153 pregnant women at high risk for preterm delivery were examined. A study group included 82 pregnant women with the Dr. Arabin pessary. A comparison group (2) consisted of 71 patients with the circular cervical stitch. Results. In the use of the Dr. Arabin obstetric pessary versus the circular cervical stitch, changes in vaginal biocenosis were 2.5 and almost 3 times more rare during pregnancy (p=0.015) and postpartum period (p=0.037), respectively. In the comparison group, the stitch was seen to be cut in 4.3% of cases. Patients with abnormal arrangement of the placenta were observed to have its migration in 62.1 and 52.1% of those having the cervical pessary or the stitch, respectively. Bleeding during pregnancy was significantly more common in the comparison group (p=0.005). In the comparison group, the incidence of hypotonic bleedingwas 16.9% (p=0.034). Moreover, the parturients in the comparison group were noted to develop chorioamnionitis during delivery in 2.8% of cases. Conclusion. The application of the Dr. Arabin obstetric pessary versus the circular cervical stitch decreases the risk of infective complications and bleeding during pregnancy and postpartum period.

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About the authors

Sergey Vladimirovich Barinov

Omsk State Medical University, Ministry of Health of Russia

Email: barinov_omsk@mail.ru
Doctor of Medical Sciences, Professor, head of the Department of Obstetrics and Gynecology Ns 2 Omsk 644043, Lenina str. 12, Russia

Inna Vasilievna Shamina

Omsk State Medical University, Ministry of Health of Russia

Email: innadocsever@rambler.ru
Candidate of Medical Science, Assistant of the Department of Obstetrics and Gynecology Ns 2 Omsk 644043, Lenina str. 12, Russia

Oksana Vyacheslavovna Lazareva

Regional Clinical Hospital

Email: lazow@mail.ru
Candidate of Medical Science, Assistant of the Department of Obstetrics and Gynecology Ns 2 Omsk 644043, Lenina str. 12, Russia

Vyacheslav Vladimirovich Ralko

Regional Clinical Hospital

Email: akusheromsk@rambler.ru
Candidate of Medical Science, Deputy Chief of obstetric and gynecological care, Perinatal Center Omsk 644011, Berezovaya 3, Russia

Lyudmila Leonidovna Shkabarnya

Regional Clinical Hospital

Email: l_shka@mail.ru
obstetrician-gynecologist, head of the gynecological department, Perinatal Center Omsk 644011, Berezovaya 3, Russia

Galina Vladimirovna Dudkova

Regional Clinical Hospital

Email: ms.dudkova@mail.ru
obstetrician-gynecologist, head of the Department of Reproductive and Perinatal Medicine, Perinatal Center Omsk 644011, Berezovaya 3, Russia

Lyudmila Leonidovna Klementeva

000 "Alfa EmBio"

Email: kll_embio@mail.ru
obstetrician-gynecologist Omsk 644043, Lenina str. 12, Russia

Olga Vyacheslavovna Vladimirova

Omsk State Medical University, Ministry of Health of Russia

Email: vladimirovaovomsk@yandex.ru
resident doctor of the Department of Obstetrics and Gynecology N° 2 Omsk 644043, Lenina str. 12, Russia

References

  1. Стрижаков А.Н., Давыдов А.И., Игнатко И.В., Белоцерковцева Л.Д. Невынашивание беременности: патогенез, диагностика, лечение. Клиническое руководство. М.; 2011. 72с.
  2. Егорова Я.А., Рыбалка A.H. Разгружающий акушерский пессарий как дополнение к лечению истмико-цервикальной недостаточности. Крымский журнал экспериментальной и клинической медицины. 2014; 4(2): 17-21.
  3. Профилактика невынашивания и преждевременных родов в современном мире. Резолюция Экспертного совета в рамках 16-го Всемирного конгресса по вопросам репродукции человека (Берлин, 18-21 марта 2015года). Информационное письмо. М.: StatusPraesens; 2015. 4с.
  4. Blencowe H., Cousens S., Oestergaard M.Z., Chou D., Moller A.B., Narwal R. et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012; 379(9832): 2162-72.
  5. Сидельникова B.M., Сухих Г. T Невынашивание беременности. Руководство для практикующих врачей. М.: МИА; 2010. 534с.
  6. Ледина A.B., Абуд И.Ю. Истмико-цервикальная недостаточность. В кн.: Прилепская В.Н., ред. Заболевания шейки матки (клинические лекции). М.: Медиа Сфера; 1997: 81-5.
  7. Журавлёв А.Ю., Журавлёв Ю.В., Дроздов C.A., Кичигина В.В. Течение беременности и родов при коррекции ИЦН с помощью акушерского пессария. В кн.: Репродуктивная функция женщин Беларуси в современных экологических условиях. Сборник научных работ VI съезда акушеров-гинекологов и неонатологов Беларуси. Минск; 2007: 146-50.
  8. Садаускас B.M., Максимайтене ДА. Влияние тактики лечения при предлежании плаценты на исход беременности. Акушерство и гинекология. 1983; 10: 32-4.
  9. Скорнякова Л.М., Коликов А.И. Особенности родоразрешения беременных с предлежанием плаценты. В кн.: Сухих Г.Т., ред. Материалы 4-го съезда акушеров-гинекологов России. Москва 30 сентября - 2 октября 2008 г. М.; 2008: 238-9.
  10. Liu L., Johnson H.L., Cousens S., Perin J., Scott S., Lawn J.E. et al. Global, regional and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012; 379(9832): 2151-61.
  11. Cannie M.M., Dobrescu O., Gucciardo L., Strizek В., Папе S., Sakkas E. et al. Arabin cervical pessary in women at high risk of preterm birth: a magnetic resonance imaging observational follow-up study. Ultrasound Obstet. Gynecol. 2013; 42(4): 426-33.
  12. Liem S.M., van Pampus M.G., Mol B.W., Bekedam D.J. Cervical pessaries for the prevention of preterm birth: a systematic review. Obstet. Gynecol. Int. 2013; 2013: Article ID 576723.
  13. Berghella V., Keeler S.M., To M.S., Althuisius S.M., Rust O.A. Effectiveness of cerclage according to severity of cervical length shortening: a meta-analysis. Ultrasound Obstet. Gynecol. 2010; 35(4): 468-73.
  14. Zimerman A.L., Neeman O., Wiener Y., Maymon R., Arie H. First year experience using arabin cervical pessary with intravaginal micronized progesterone for the prevention of preterm birth in patients with mid-trimester short cervix. Harefuah. 2014; 153(2): 79-82,127.
  15. Arabin B., Halbesma J.R., Vork E, Hubener M., van Eyck J. Is treatment with vaginal pessaries an option in patients with a sonographically detected short cervix? J. Perinat. Med. 2003; 31(2): 122-33.
  16. Winnie S.M., Karau P, Mutwiri M., Julius O., Geoffrey M. Outcome and complications in women undergoing cervical cerclage in a tertiary hospital in Kenya. WebmedCentral: Obstetrics and Gynaecology. 2010; 1(9): Article ID WMC00793.

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