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BioMed Research International
Volume 2015, Article ID 185371, 6 pages
http://dx.doi.org/10.1155/2015/185371
Clinical Study

Adjunctive Pessary Therapy after Emergency Cervical Cerclage for Cervical Insufficiency with Protruding Fetal Membranes in the Second Trimester of Pregnancy: A Novel Modification of Treatment

11st Department of Obstetrics and Gynecology, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland
2Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Ulica Banacha 1A, 02-097 Warsaw, Poland

Received 12 February 2015; Revised 20 May 2015; Accepted 24 May 2015

Academic Editor: Igor Hudic

Copyright © 2015 Katarzyna Kosinska-Kaczynska et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To evaluate the effectiveness of adjunctive pessary therapy after emergency cervical cerclage (ECC) in improving perinatal outcome in cervical insufficiency with fetal membranes protruding into the vagina. Material and Methods. A retrospective analysis of patients treated at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between 2008 and 2013. The study group consisted of 15 women treated with ECC and a pessary and the control group consisted of 17 patients treated with cerclage only. Results. The mean gestational age at delivery was significantly higher in the study group (34.7 versus 29.7 weeks, ). The period between cerclage insertion and delivery was significantly longer in the study group (82.9 versus 52.1 days, ). The mean neonatal birthweight and neonatal “discharge alive” ratio were higher in the study group, although not statistically significant (2550 g versus 1883 g, , and 93.3% versus 70.5%, , resp.). NICU hospitalization rates were comparable (33.3% versus 35.3%, ). Conclusions. Adjunctive pessary therapy allows delaying delivery in women treated with ECC due to cervical insufficiency with protruding fetal membranes. It also seems to improve neonatal outcome, although the differences are not statistically significant. Further prospective study is required to prove these findings.