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Tytuł pozycji:

Arabin cervical pessary with vaginal progesterone versus vaginal progesterone for preventing preterm delivery.

Tytuł:
Arabin cervical pessary with vaginal progesterone versus vaginal progesterone for preventing preterm delivery.
Autorzy:
Melcer Y; Department of Obstetrics and Gynecology, the Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Zerifin, Israel.
Kovo M; Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel (both affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel).
Maymon R; Department of Obstetrics and Gynecology, the Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Zerifin, Israel.
Bar J; Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel (both affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel).
Wiener I; Department of Obstetrics and Gynecology, the Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Zerifin, Israel.
Neeman O; Department of Obstetrics and Gynecology, Assuta Hospital, Ashdod, Israel (affiliated to University of the Negev, Beer-Sheva, Ben-Gurion, Israel).
Pekar-Zlotin M; Department of Obstetrics and Gynecology, the Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Zerifin, Israel.
Zimerman A; Department of Obstetrics and Gynecology, the Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Zerifin, Israel.
Źródło:
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2020 Oct; Vol. 33 (20), pp. 3439-3444. Date of Electronic Publication: 2019 Feb 04.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: London : Informa Healthcare
Original Publication: Boca Raton : Parthenon Pub. Group, c2002-
MeSH Terms:
Pessaries*
Premature Birth*/epidemiology
Premature Birth*/prevention & control
Administration, Intravaginal ; Cervix Uteri/diagnostic imaging ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Progesterone ; Retrospective Studies
Contributed Indexing:
Keywords: Cervical pessary; preterm birth; progesterone; short cervical length; transvaginal ultrasound
Substance Nomenclature:
4G7DS2Q64Y (Progesterone)
Entry Date(s):
Date Created: 20190124 Date Completed: 20210617 Latest Revision: 20210617
Update Code:
20240105
DOI:
10.1080/14767058.2019.1573894
PMID:
30669913
Czasopismo naukowe
Purpose : To compare the rate of preterm delivery in pregnant women with a short cervical length managed with Arabin cervical pessary and vaginal progesterone versus vaginal progesterone alone. Methods: This was a retrospective cohort study of singletons pregnancies managed in two tertiary medical centers between September 2011 and May 2017. One center utilized the combined treatment of Arabin cervical pessary and vaginal progesterone (study group) and the second utilized vaginal progesterone approach (control group). Results: During the study period, a total of 202 pregnant women who underwent vaginal ultrasonography between 15 and 29 weeks gestation. They all had short cervical length (≤25 mm). Among them, 94 (46.5%) and 108 (53.5%) patients were in the study and control group, respectively. A significantly higher rate of patients in the study group had either a history of cervical incompetence (9.6 vs. 0.9%, respectively, p  = 0.006) or cervical surgery (7.9 vs. 0%, respectively, p  = .003). Despite having shorter cervical length at recruitment (14.3 ± 5.9 vs. 16.9 ± 5.7, respectively, p  = .002) the rate of spontaneous delivery < 34-week gestation was lower in the study group (7.4 vs. 17.6%, respectively, p  = .036) and they delivered 1-week later compared to the control group (37.2 ± 2.1 vs. 36.2 ± 3.7, respectively, p  = 0.02). Conclusion: We found that for pregnant women with singletons and who had a short cervical length, the combined treatment of Arabin cervical pessary and vaginal progesterone had lower rate of preterm delivery < 34 weeks of gestation and prolonged gestation compared to those women who were treated with vaginal progesterone alone. Our preliminary findings warrant randomized control studies in order to further illuminate our results.

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