[Using Cervical Pessary to Prevent Premature Birth - a Clinical Analysis]

Area of Science:

• Maternal-Fetal Medicine
• Obstetrics
• Gynecology

Background:

• Cervical shortening before 34 weeks gestation can necessitate interventions like cervical pessary insertion per German guidelines.
• The efficacy of cervical pessaries in preventing premature birth remains a subject of debate.

Purpose of the Study:

• To evaluate the effectiveness of cervical pessary insertion in extending gestational age.
• To assess the impact of cervical pessaries on preterm birth rates in high-risk and low-risk groups.
• To analyze the tolerability and adherence of this intervention.

Main Methods:

• Retrospective analysis of 83 patients who received a cervical pessary between 20-32 weeks gestation.
• Categorization into high-risk (<15mm cervical length) and low-risk (15-25mm cervical length) subgroups.
• Literature review on the topic of cervical pessary use for preterm birth prevention.

Main Results:

• Preterm birth occurred in only 20% of cases across both subgroups.
• 79% of patients delivered after 34 weeks gestation, and 59% delivered after 37 weeks.
• The intervention demonstrated a reduction in hospitalization rates.

Conclusions:

• Cervical pessary use, combined with local progesterone, is a well-tolerated intervention with minimal side effects and good adherence.
• This approach appears to reduce hospitalizations, despite conflicting evidence in the literature.
• The findings suggest a beneficial role for cervical pessaries in managing cervical shortening to prevent preterm birth.