[Herbich cervical pessary--method of therapy for cervical incompetence and prophylaxis of prematurity].
Cervical incompetence is often complication in the II and III trimester of pregnancy and is a cause of 16-20% of premature deliveries. Treatment of incompetent cervix contains surgical methods ( cerclage and others) and conservative management as follow: tocolytics, hormones, bed rest and mechanical factors (pessary, rings, balloons etc). The aim of the study was evaluation of therapeutical efficacy Herbich cervical pessary in the cases of cervical incompetence I and II degree in II and III trimester of pregnancy. Study included 73 pregnant women with cervical incompetence diagnosed on the basis of clinical examination and measurements of cervical length during transvaginal ultrasonography (Voluson 730 Kretz, ATL HDI 1000). After diagnosis we inserted into vagina pessary size 1 or 2 around incompetent cervix. We divided examination group into primipara and multipara. In our research we obtained no statistically significant differences between both groups in the percentage of premature deliveries, the mode of delivery and prolong time of pregnancy. High percentage of prematurity (35.7%) was a cause of two fetal death (2.75%) delivered in the 25 week of pregnancy. Cervical pessary prolonged time of pregnancy about 12-17 weeks and for this reason almost all labors were after 33 weeks of pregnancy (89%). Cervical pessary of Herbich is a safe and effective method of treatment for cervical incompetence of I and II degree. This pessary decreases percentage of prematurity in the high risk group of pregnant women with incompetent cervix.
Grzonka
Dariusz T
DT
Z Katedry i Kliniki Perinatologii i Ginekologii w Zabrzu. patpregr@slam.katowice.pl
Kaźmierczak
Wojciech
W
Cholewa
Dariusz
D
Radzioch
Jarosław
J
D000328:Adult; D023802:Cerclage, Cervical; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000517:prevention & control* / Q000628:therapy; D010570:Pessaries / Q000706:statistics & numerical data*; D011044:Poland; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D018566:Pregnancy, High-Risk; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D002581:Uterine Cervical Incompetence / Q000601:surgery / Q000628:therapy*