title: Rupture of the cervix during pregnancy after cervical pessary insertion for preventing preterm birth.
abstract: We present a rare case of a complication after pessary insertion during pregnancy due to short cervix. A woman in the 35th week of gestation was admitted to the Department of Perinatology due to preterm labor. The patient's history revealed cervical pessary insertion during the 29th week of pregnancy due to a cervix of 18 mm in length. Because of threatened preterm labor, the pessary was removed. After pessary removal, a rupture of the cervix was diagnosed. Because of active labor and cervical rupture, a cesarean section was performed and a healthy newborn was delivered. After cesarean section the cervical rupture was sutured. Five days after the operation, the patient underwent surgery again due to a necrotically changed part of the cervix. This part of the cervix was removed. We present this case to emphasize that cervical pessaries can cause serious complications during pregnancy. Clinicians should take this into consideration before qualifying patients for pessary insertion.
authors.affiliation: Department of Perinatology, First Chair of Gynaecology and Obstetrics, Medical University of Lodz, Poland.
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Kalinka
authors.affiliation: Department of Perinatology and Obstetrics, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Elwira Agata
authors.initials: EA
authors.lastname: Jasinska
authors.affiliation: Department of Perinatology and Obstetrics, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Laudanski
authors.affiliation: Department of Perinatology, First Chair of Gynaecology and Obstetrics, Medical University of Lodz, Poland.
authors.forename: Adam
authors.identifier: http://orcid.org/0000-0001-6599-7890
authors.initials: A
authors.lastname: Bitner
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D010570:Pessaries / Q000009:adverse effects*; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control* / Q000601:surgery*; D014597:Uterine Rupture / Q000601:surgery*
keywords: incompetent cervix; obstetric complications; premature labor; prematurity - risk assessment and prevention