Cervical pessary

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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. [2] More medical studies are needed to decide whether a cervical pessary is equal to or the best treatment. [2] [3]

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<span class="mw-page-title-main">Cervical cerclage</span> Obstetrics medical procedure

Cervical cerclage, also known as a cervical stitch, is a treatment for cervical weakness, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. In women with a prior spontaneous preterm birth and who are pregnant with one baby, and have shortening of the cervical length less than 25 mm, a cerclage prevents a preterm birth and reduces death and illness in the baby.

Cervical weakness, also called cervical incompetence or cervical insufficiency, is a medical condition of pregnancy in which the cervix begins to dilate (widen) and efface (thin) before the pregnancy has reached term. Definitions of cervical weakness vary, but one that is frequently used is the inability of the uterine cervix to retain a pregnancy in the absence of the signs and symptoms of clinical contractions, or labor, or both in the second trimester. Cervical weakness may cause miscarriage or preterm birth during the second and third trimesters. It has been estimated that cervical insufficiency complicates about 1% of pregnancies, and that it is a cause in about 8% of women with second trimester recurrent miscarriages.

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<span class="mw-page-title-main">Infant massage</span>

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Amnioinfusion is a method in which isotonic fluid is instilled into the uterine cavity.

References

  1. Alfirevic, Zarko; Stampalija, Tamara; Medley, Nancy (2017). "Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy". The Cochrane Database of Systematic Reviews. 2017 (6): CD008991. doi:10.1002/14651858.CD008991.pub3. ISSN   1469-493X. PMC   6481522 . PMID   28586127.
  2. 1 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 (5): CD007873. doi:10.1002/14651858.CD007873.pub3. PMC   6491132 . PMID   23728668.
  3. Abdel-Aleem, Hany; Shaaban, Omar M; Abdel-Aleem, Mahmoud A; Aboelfadle Mohamed, Ahmed (1 December 2022). "Cervical pessary for preventing preterm birth in singleton pregnancies". Cochrane Database of Systematic Reviews. 2022 (12): CD014508. doi:10.1002/14651858.CD014508. PMC  9713761. PMID   36453699.