Experience in managing pregnant women at high risk for preterm birth, by using a dome-shaped obstetric pessary and cerclage


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Abstract

Objective. To determine the predictors of miscarriage and to evaluate the efficacy of a dome-shaped obstetric pessary and surgical cerclage in the management of pregnancy in a group at high risk for miscarriage. Resu1ts. First-trimester threatened miscarriage was observed in 29.8% (48/161) of cases in Group 1 and in 37.9% in Group 2. Postpartum hemorrhage was diagnosed in 8.1% (13/161) of the puerperas in the study group and in 22.8% (18/79) in the comparison group (χ2 = 6.500; p = 0.011). Surgical cerclage is more preferable for isthmic-cervical insufficiency of organic origin, a cervical length less than 15 mm, and a large isthmic myomatous nodule. Pessary placement enables preterm birth to be reduced by 1.7 times. Conclusion. An integrated approach to pregnancy management allows a reduction in the number of premature births.

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About the authors

Sergey V. Barinov

Omsk State Medical University Ministry of Health of Russia

Email: barinov_omsk@mail.ru
MD, professor, head of the Department of Obstetrics and Gynecology №2

Natalia V. Artymuk

Kemerovo State Medical University Ministry of health of Russia

Email: artymuk@gmail.com
MD, professor, head of the Department of Obstetrics and Gynecology № 2

Oksana N. Novikova

Kemerovo State Medical University Ministry of health of Russia

MD, professor, Department of Obstetrics and Gynecology № 2

Inna V. Shamina

Omsk State Medical University Ministry of Health of Russia

Email: innadocsever@rambler.ru
PhD, assistant of the Department of Obstetrics and Gynecology №2

Yuliya I. Tirskaya

Omsk State Medical University Ministry of Health of Russia

Email: akusheromsk@rambler.ru
MD, professor of Obstetrics and Gynecology Department № 2

Antonina A. Belinina

Altay Regional Clinical Perinatal Center

Email: antonina_belinina@mail.ru
obstetrician-gynaecologist

Oksana V. Lazareva

Omsk State Medical University Ministry of Health of Russia

Email: lazow@mail.ru
PhD, assistant of the Department of Obstetrics and Gynecology № 2

Tatyana V. Kadtsyna

Omsk State Medical University Ministry of Health of Russia

Email: akusheromsk@rambler.ru
PhD, assistant of the Department of Obstetrics and Gynecology № 2

Ekaterina A. Frikel

BUZOO “Regional Clinical Hospital”

Email: kkrk@rambler.ru
obstetrician-gynecologist of the Department of Reproductive and Perinatal Medicine of the Perinatal Center

Olga Yu. Atamanenko

BUZOO “Regional Clinical Hospital”

Email: akusheromsk@rambler.ru
obstetrician-gynecologist of the Department of Reproductive and Perinatal Medicine of the Perinatal Center

Olga V. Ostrovskaya

Omsk State Medical University Ministry of Health of Russia

Email: akusheromsk@rambler.ru
post-graduate student of the Department of Obstetrics and Gynecology № 2

Sergey S. Stepanov

Omsk State Medical University Ministry of Health of Russia

Email: serg_stepanov@mail.ru
MD, senior laboratory assistant of the Department of Histology

Dmitry E. Beglov

Kemerovo State Medical University

Email: beglic@gmail.com
post-graduate student of the Department of Obstetrics and Gynecology №2

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