Monday, July 28, 2014

Pessary for incompetent cervix

I found some interesting information on Pessary. I spoke with a MFM specialist in N.C who stated he is unsure what to do in my case. He stated he can do my TAC better not to sound arragant. After that phone call I was not feeling very hopeful as I have had 3 physicans lost and not knowing what to do with my case. While doing some research I found one word in a document I was reading where they have had only one study done, it's very promising and very inexpensive. I found a support group on baby center community and there are women who have tried the pessary as a cerclage with and without a cerclage and have had a successful pregnancy with no bed rest. I plan on speaking to my OB tomorrow about it and my MFM about it on 8/8th. I want to add this pessary with my TAC and a TVCIC. What I've noticed is all of the physicans who are using this techinque is located in the North, New York my home town. I feel the doctor's in Atlanta are not educated enough for my health. Hopefully one of them can direct my MFM on this new technique or hopefully he has already tried the technique.

Use of cervical pessary—a small, silicone, ring-shaped device inserted around the cervix—is a safe, inexpensive, and reliable alternative for preventing preterm delivery in women with a short cervix, according to the authors of a new study conducted in Spain. - See more at:

This study is the first randomized controlled trial testing the usefulness of cervical pessary for preventing preterm births. Cervical pessaries, which have been used for about 50 years as an option for delaying preterm births, have been studied previously with favorable results, but the evidence comes from nonrandomized study designs. - See more at:

The study involved 385 women aged 18 to 43 years identified as having a short cervix (25 millimeters or less) at a routine transvaginal ultrasound at 20 to 23 weeks of gestation. The women were randomly assigned to either the pessary group (n=192) or the expectant management group (n=193), and 190 women from each group were followed. The number of spontaneous deliveries before 34 weeks of gestation was significantly less in the pessary group than in the expectant management group - See more at:

Although the findings are promising, additional larger studies are needed to ascertain whether eligibility for this intervention should be based solely on cervical length or other risk factors for preterm delivery. In addition, because of the small sample size of this study, there were very few adverse outcomes. Several larger studies are needed to determine possible risks of this intervention as well as the effectiveness of this intervention in routine practice. Currently, a randomized, multicenter study in England and other countries is underway to determine the usefulness of cervical pessary in twin pregnancies. - See more at:

Pertinent Points:
- With pessary use, a 21% absolute reduction of risk of preterm delivery was noted.
- Average gestation in the pessary group was 37.7 weeks, compared with 34.9 weeks in the expectant management group—a statistically significant difference. Subsequently, significantly fewer newborns from the pessary group had a birth weight of less than 2.5 kg (5.5 lb).
- There was a significantly higher need in the expectant management group to suppress labor using medication and to administer corticosteroids to accelerate fetal lung maturation.
- Although insertion and removal of the pessary was reported as painful, 95% of pessary recipients would recommend the intervention.
- See more at:

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