Comparative effectiveness of the dome-shaped pessary versus cerclage using the Lubimova technique in the prevention of preterm birth in high-risk women


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Objective: To compare the effectiveness of a dome-shaped pessary and cerclage using the Lubimova technique in combination with progesterone in high-risk women to prevent preterm birth. Materials and methods: This retrospective case-control study included 200 women. Group I (n=100) consisted of women with isthmic cervical insufficiency (ICI) who underwent a dome-shaped obstetric pessary placement; Group II (n=100) included women with ICI who underwent cerclage. The primary outcome was preterm birth (PB) before 37, 34 and 28-weeks’ gestation. Secondary outcomes were anthropometric parameters of the newborn (weight, chest, and abdominal circumference), Apgar score, the proportion of low-birth-weight babies and the proportion requiring transfer to the second stage of nursing, as well as the incidence of hypoxic brain damage in newborns. Results: The proportion of pregnancies that ended in PB did not differ statistically significantly between the groups and was 43 (43.0%) and 41 (41.0%) in Groups I and II, respectively, p=0.375. No differences were found in PB rates in the study groups up to 28, 34, and 37 weeks of gestation. Group I neonates did not differ statistically significantly from Group II neonates in basic anthropometric indices (body weight, head and chest circumferences), Apgar score, need for respiratory support, and frequency of CNS affection. However, the rate of intraventricular hemorrhage in Group I neonates was twice lower [7 (7.0%) vs. 15 (15.0%)], p=0.071, and transfer to the second stage of nursing was statistically significantly lower [46 (46.0%) vs. 60 (60.0%)], p=0.048. Conclusion: The use of a dome-shaped pessary and cerclage using the Lubimova technique in combination with progesterone in high-risk patients resulted in that almost half of them carried their pregnancies to full term. The pessary has certain advantages for newborns in terms of a lower incidence of intraventricular hemorrhage and transfer to the second stage of nursing.

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作者简介

Natalia Artymuk

Kemerovo State Medical University

Email: artymuk@gmail.com
Dr. Med. Sci., Professor, Head of the G.A. Ushakova Department of Obstetrics and Gynecology

Sergey Barinov

Omsk State Medical University

Email: barinov_omsk@mail.ru
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. i

Oxana Novikova

Kemerovo State Medical University

Email: oxana777_07@mail.ru
Dr. Med. Sci., Professor at the G.A. Ushakova Department of Obstetrics and Gynecology

Dmitriy Beglov

Kemerovo State Medical University

Email: beglik@gmail.com
Postgraduate Student at the G.A. Ushakova Department of Obstetrics and Gynecology

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