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| Author | Year | Country | No. of women | Inclusion criteria | Exclusion criteria | Age | Type of pessary | Pregnancy outcome | Neonatal outcome | Pessary removal and side effects |
|
| Quaas | 1990 | Germany | 107 |
Women with history of miscarriages
Preterm birth, multiple pregnancies,
Cervical conization, cervical tear, cervical
Ripening (bishop score >6), dilation or
Prolapsed membranes | Not clearly stated | Not stated | Arabin | 92% of women treated with pessary delivered >36 weeks | Not stated | 36 weeks of gestation |
|
| Arabin | 2003 | The Netherlands | 11 | History of spontaneous preterm birth <36 weeks and a CL <15 mm (singletons and twins) | Severe regular contractions
Blood loss
Premature rupture of membranes | 24–43 years | Arabin |
Singletons:
mean GA at delivery 35 + 3 weeks
Twins:
mean GA at delivery 35 weeks
Pessary versus control:
singletons <28 weeks: 0 (0%) versus 2 (17%)
<32 weeks: 0 (0%) versus 3 (25%)
<36 weeks: 0 (0%) versus 6 (50%)
Pessary versus control: twins
<28 weeks: 0 (0%) versus 1 (4%)
<32 weeks: 0 (0%) versus 7 (30%)
<36 weeks: 8 (35%) versus 12 (52%) | Not stated | 17 (58%) complains of discharge
13 (44%) pain during insertion
15 (52%) pain during removal
28 (97%) recommend to others |
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| Antczak-Judycka | 2003 | Poland | 57 | Women with a risk of PTB:
shortening of cervical length or dilatation between 22–27 weeks | Intrauterine infection
contractions
Urine tract infection
Vaginal infection | 20–46 | Not defined |
Cerclage versus pessary
Prolongation of pregnancy:
13.4 (±3 weeks) versus 12.1 (±3 weeks)
Mean GA at delivery:
37.3 (±2 weeks) versus 37.7 (±3 weeks)
Delivery >37 weeks:
17 (77%) versus 31 (89%) | Cerclage versus pessary
birthweight:
3080 ± 676 versus 3063 ± 826
Apgar score 5 min: “good”
perinatal death:
2 (6%) pessary group | Cerclage versus pessary
PPROM: 1 (5%) versus 2 (6%)
Premature contractions: 2 (10%) versus 2 (6%)
Cervical tear: 3 (15%) cerclage group
Pessary dislocation: 1 (3%) |
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| Acharya | 2006 | Norway | 32 (21 singletons, 9 twins, 2 triplet) | Women with a riskfactor for PTB and a short CL (<25 mm) before 30 weeks of GA | No viable fetus or congenital malformations | 23–39 years | Arabin | Delivery <28 weeks: 6 (20.7%)
Delivery <34 weeks: 13 (45%)
Mean GA at delivery 34 weeks | Mean birthweight: 2255 g
Mean Apgar score at 5 min: 8
Perinatal death: 4 (14%) | 34 + 36 weeks
2 removal due to pain
Increased discharge in all women |
|
| Sieroszewski | 2009 | Poland | 54 | Singleton pregnancies with a CL 15–30 mm before 28 weeks |
Multiple pregnancies
Fetal malformations
Uterine contractions
PPROM
Blood loss
Abnormal placenta localisation | <20 years 1 (1.9%)
20–34 years 47 (87%)
35–39 years 4 (7.4%)
>37 years 2 (3.7%) | Arabin | Delivery <37 weeks: 9 (16.7%)
Mean GA at delivery 35.3 weeks | Apgar score scales:
0–4: 2 children (3.7%)
5–7: 7 (13%)
8–10: 45 (83.3%)
NICU admission: 2 (39%)
0 neonatal deaths | Mean gestational age at removal 33.3 weeks
No complications or side effects |
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| Kimber-Trojnar | 2010 | Poland | 56 | Women with a riskfactor for PTB: history miscarriages, prior PTB <34 weeks, cervical suture in previous pregnancy, history of cervical | Contractions, ruptured membranes, maternal pyrexia, elevated CRP or white blood cell count, vaginal | 19–43 years | Polyvinyl chloride pessary | Delivery <34 weeks: 2 (3.6%)
Delivery 34–37 weeks: 6 (10.7%)
Delivery >37 weeks: 48 (85.7%) | Mean birthweigth: 3255
Mean Apgar score at 3 min: 9, 6
58 (100%) live born infants
7 (12.5%) NICU admission | 37 weeks, contractions vaginal bleeding, discomfort fetal distress, ruptured membranes |
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