Comparative Evaluation of Arabin Pessary and Cervical Cerclage for the Prevention of Preterm Labor in Asymptomatic Women with High Risk Factors

• Published in: International journal of environmental research and public health Vol. 15; no. 4; p. 791
• Main Authors: Tsikouras, Panagiotis, Anastasopoulos, George, Maroulis, Vasileios, Bothou, Anastasia, Chalkidou, Anna, Deuteraiou, Dorelia, Anthoulaki, Xanthoula, Tsatsaris, Georgios, Bourazan, Arzou Halil, Iatrakis, George, Zervoudis, Stefanos, Galazios, Georgios, Inagamova, Lola-Katerina, Csorba, Roland, Teichmann, Alexander-Tobias
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 18-04-2018; MDPI
• Subjects: Biochemical markers; Cerclage, Cervical; Cervix; Complications; Democritus (460?-370?); Female; Gynecology; Humans; Infections; Labor; Mortality; Obstetric Labor, Premature - prevention & control; Obstetrics; Pessaries; Pregnancy; Pregnancy complications; Pregnancy Trimester, First; Pregnancy Trimester, Second; Premature birth; Prevention; Prolongation; Risk analysis; Risk Factors; Sutures; Systematic review; Teaching hospitals; Ultrasonic imaging; Ultrasound; Uterus; Womens health; Thrace; Greece; Germany; cervical Arabin pessary; cerclage; second trimester of pregnancy
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph15040791

Preterm labor is one of the most significant obstetric problems associated with high rate of actual and long-term perinatal complications. Despite the creation of scoring systems, uterine activity monitoring, cervical ultrasound and several biochemical markers, the prediction and prevention of preterm labor is still a matter of concern. The aim of this study was to examine cervical findings for the prediction and the comparative use of Arabin pessary or cerclage for the prevention of preterm birth in asymptomatic women with high risk factors for preterm labor.
The study group was composed of singleton pregnancies (spontaneously conceived) with high risk factors for preterm labor. Cervical length, dilatation of the internal cervical os and funneling, were estimated with transvaginal ultrasound during the first and the second trimesters of pregnancy.
Cervical funneling, during the second trimester of pregnancy, was the most significant factor for the prediction of preterm labor. The use of Arabin cervical pessary was found to be more effective than cerclage in the prolongation of pregnancy.
In women at risk for preterm labor, the detection of cervical funneling in the second trimester of pregnancy may help to predict preterm labor and to apply the appropriate treatment for its prevention. Although the use of cervical pessary was found to be more effective than cerclage, more studies are needed to classify the effectiveness of different methods for such prevention.