[Using Cervical Pessary to Prevent Premature Birth - a Clinical Analysis]. / Vermeidung der Frühgeburt durch Einlage eines Zerclage-Pessars ­ Eine klinische retrospektive Kohortenanalyse.

ABSTRACT

OBJECTIVE: In the event of a cervical shortening < 25 mm before the 34th week of gestation, a cervical pessary can be inserted in accordance with the German AMWF guidelines. However, data concerning the benefit of this intervention in order to avoid premature birth are controversial. METHODS: Between the 20th and 32nd week of gestation, we inserted a cervical pessary in 83 patients and evaluated our data with regard to the extension of gestational age due to this intervention. We also reviewed the literature on this topic. We retrospectively analysed the data in a high-risk group (cervical length<15 mm) and a low-risk group (15-25 mm). RESULTS: Our data show a preterm birth in just 20% of all cases in both subgroups. 79% of the patients gave birth after 34 weeks and 59% after 37 weeks. CONCLUSIONS: Our approach using an cervical pessary supported by local application of progesterone seems to be a well-tolerated intervention with few side effects and acceptable adherence. In addition, our data demonstrate a reduction in hospitalization, even though the evidence is divergent in this respect.