• Experience of using load-carrying cervical pessaries for prevention of preterm birth in women with a multiple pregnancy

Experience of using load-carrying cervical pessaries for prevention of preterm birth in women with a multiple pregnancy

PERINATOLOGIYA I PEDIATRIYA. 2017.1(69):51-58; doi 10.15574/PP.2017.69.51

Experience of using load-carrying cervical pessaries for prevention of preterm birth in women with a multiple pregnancy

Nikitina I. M.

Sumy State University, Ukraine

Purpose — to estimate efficiency of using load-carrying cervical pessaries in women with a multiple pregnancy and a high risk of preterm birth.

Materials and methods. The first group of the study consisted of 40 participants with twin pregnancies, whom were inserted load-carrying cervical pessaries considering the signs of preterm birth at 18–28 weeks of gestation. The 12 pregnant women with twin gestations of the second group were treated by applying cervical cerclage because of cervical insufficiency. The control group of 18 pregnant women with twin gestations received conservative treatment. The analysis of pregnancy follow-up, childbirth, postpartum period and neonatal adaptation in the survey groups were performed.

Results. The follow-up control revealed more slowly effacement of the uterine cervix in patients of the inserted pessaries group. It is the efficient method of prevention and treatment of miscarriage in women with multiple pregnancy that decrease the rates of late miscarriage and a loss, and preterm birth, and perinatal loss. The premature rupture of the foetal membrane was observed in 7 patients (17.5%) of the first group, in 3 cases (25.0%) of the II group and in 5 women (27.7%) of the control group. The full term delivery was observed in 34 patients (85.0%) of the first group, in 9 cases (75.0%) of the II group, and in 12 of patients (66.6%) in control group. The perinatal losses in the control group make up 2.7%. While in the first group, no perinatal losses were noticed. In making an assessment of postnatal adaptation of neonates of all survey groups, the reducing body mass index was reported in the second and control groups, as well as the decrease of Apgar score was recorded in the same groups.

Conclusions. Treatment with a load-carrying cervical pessary is a pathogenetic therapy in pregnant women with multiple pregnancy and allowed to prevent pre-time birth in women with twin gestations in 85% of women according to our study, reduce the administration of medications and its harm on pregnant woman and foetus.

Key words: multiple pregnancy, miscarriage, load-carrying cervical pessary.

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