title: Arabin cerclage pessary in the management of cervical insufficiency.
abstract: OBJECTIVE
  To evaluate the use of Arabin cerclage pessary in the management of cervical insufficiency.
  
  
  METHODS
  The pregnancy outcome of 20 women carrying singleton pregnancy referred for suspected cervical insufficiency and chose Arabin cerclage pessary for treatment from 2009-2011 were reviewed. Pregnancy outcome were analysed according to presence of risk factors, amniotic fluid sludge, cervical length and gestation at pessary insertion.
  
  
  RESULTS
  At presentation, mean cervical length was 1.17 cm (range 0-2.33 cm), mean gestation at pessary insertion and delivery was 20.6 (12.9-26.1) weeks and 32.1 (14.7-40.1) weeks, respectively, and mean prolongation of pregnancy was 11.5 (0.5-25.2) weeks. Overall, 5 (25%) had fetal loss between 14.7-23.1 weeks, while 3 (15%) and 12 (60%) delivered before and after 34 weeks gestation, respectively with no perinatal mortality. Compared with women with cervical length <1.5 cm, all those with cervical length ≥1.5 cm had pregnancy prolonged for ≥49 days (100 vs. 54% p = 0.032) and 86% delivered beyond 34 weeks (86 vs. 46% p = 0.085).
  
  
  CONCLUSIONS
  Arabin cerclage pessary appears to be optimal for treating women at high risk of cervical insufficiency with a cervical length of 1.5-2.5 cm, while it is an acceptable option for high risk women with cervical length <1.5 cm.
authors.affiliation: Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong ,  Shatin, Hong Kong ,  Hong Kong.
authors.forename: Yuen Ha
authors.initials: YH
authors.lastname: Ting
authors.forename: Terence T
authors.initials: TT
authors.lastname: Lao
authors.forename: Lai
authors.initials: L
authors.lastname: Wa Law
authors.forename: Shuk Yi Annie
authors.initials: SY
authors.lastname: Hui
authors.forename: Chung Ming
authors.initials: CM
authors.lastname: Chor
authors.forename: Tze Kin
authors.initials: TK
authors.lastname: Lau
authors.forename: Tak
authors.initials: T
authors.lastname: Yeung Leung
mesh_terms: D000026:Abortion, Habitual / Q000517:prevention & control; D000328:Adult; D023802:Cerclage, Cervical / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D010570:Pessaries / Q000009:adverse effects / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D002581:Uterine Cervical Incompetence / Q000601:surgery*; D014592:Uterine Hemorrhage / Q000453:epidemiology / Q000209:etiology