Cervical pessary

Cervical pessary is a medical device used to treat an incompetent (or insufficient) cervix (cervix starts to shorten and open too early). Early in the pregnancy a round silicone pessary is placed at the opening to the cervix to close it, and then it's removed later in the pregnancy when the risk of a preterm birth has passed.

Pregnant women are at risk of giving birth too early when their cervix begin to efface (shorten) and dilate (open). Different treatments have been tried to prevent a late miscarriage or preterm birth. A common treatment is cervical cerclage or stitch when a suture is stitched around the opening of the cervix around 12–14 weeks into the pregnancy.[1] A cervical pessary is being studied as an alternative to cervical cerclage since there are fewer potential complications. More medical studies are needed to decide whether a cervical pessary is equal to or the best treatment.[2] A 2016 study (encompassing 9 countries and 935 women) demonstrated that placement of a cervical pessary in women with a short cervix did not result in a lower rate of preterm delivery than the rate with expectant management.[3]

References

  1. ↑ Alfirevic, Z; Stampalija, T; Roberts, D; Jorgensen, AL (Apr 18, 2012). "Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy". The Cochrane database of systematic reviews. 4: CD008991. doi:10.1002/14651858.CD008991.pub2. PMID 22513970.
  2. ↑ Abdel-Aleem, H; Shaaban, OM; Abdel-Aleem, MA (May 31, 2013). "Cervical pessary for preventing preterm birth". The Cochrane database of systematic reviews. 5: CD007873. doi:10.1002/14651858.CD007873.pub3. PMID 23728668.
  3. ↑ Nicolaides, Kypros H.; Syngelaki, Argyro; Poon, Liona C.; Picciarelli, Gemma; Tul, Natasa; Zamprakou, Aikaterini; Skyfta, Evdoxia; Parra-Cordero, Mauro; Palma-Dias, Ricardo (2016-03-17). "A Randomized Trial of a Cervical Pessary to Prevent Preterm Singleton Birth". New England Journal of Medicine. 374 (11): 1044–1052. doi:10.1056/NEJMoa1511014. ISSN 0028-4793. PMID 26981934.
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