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


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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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作者简介

Sergey 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 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 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 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 Shkabarnya

Regional Clinical Hospital

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

Galina 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 Klementeva

000 "Alfa EmBio"

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

Olga 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

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