Experience in managing pregnant women at high risk for preterm birth, by using a dome-shaped obstetric pessary and cerclage

Barinov S.V., Artymuk N.V., Novikova O.N. , Shamina I.V., Tirskaya Yu.I. , Belinina A.A., Lazareva O.V. , Kadtsyna T.V., Frikel E.A., Atamanenko O.Yu., Ostrovskaya O.V., Stepanov S.S. , Beglov D.E.

1 Obstetrics and Gynecology Department Two, Omsk State Medical University, Ministry of Health of Russia, Omsk, Russia; 2 Perinatal Center, Regional Clinical Hospital, Omsk, Russia; 3 Kemerovo State Medical University, Ministry of Health of Russia, Kemerovo, Russia
Objective. To determine the predictors of miscarriage and to evaluate the efficacy of a dome-shaped obstetric pessary and surgical cerclage in the management of pregnancy in a group at high risk for miscarriage.
Material and methods. A total of 240 women with a high-risk pregnancy were followed up.
Resu1ts. First-trimester threatened miscarriage was observed in 29.8% (48/161) of cases in Group 1 and in 37.9% in Group 2. Postpartum hemorrhage was diagnosed in 8.1% (13/161) of the puerperas in the study group and in 22.8% (18/79) in the comparison group (χ2 = 6.500; p = 0.011). Surgical cerclage is more preferable for isthmic-cervical insufficiency of organic origin, a cervical length less than 15 mm, and a large isthmic myomatous nodule. Pessary placement enables preterm birth to be reduced by 1.7 times.
Conclusion. An integrated approach to pregnancy management allows a reduction in the number of premature births.

Keywords

obstetric pessary
circular suture of the cervix
preterm birth
isthmic-cervical insufficiency
placenta previa
obstetrical bleeding

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Received 30.11.2018

Accepted 07.12.2018

About the Authors

Barinov, Sergey V., MD, professor, head of the Department of Obstetrics and Gynecology №2, Omsk State Medical University Ministry of Health of Russia.
644043, Russia, Omsk, Lenin str. 12. Tel.: +7381224-06-58. E-mail: barinov_omsk@mail.ru
Artymuk, Natalia V., MD, professor, head of the Department of Obstetrics and Gynecology № 2, Kemerovo State Medical University Ministry of health of Russia.
650029, Russia, Kemerovo, Voroshilov str. 22A. Tel.: 79609233355. E-mail: artymuk@gmail.com
Novikova, Oksana N., MD, professor, Department of Obstetrics and Gynecology № 2, Kemerovo State Medical University Ministry of health of Russia.
650029, Russia, Kemerovo, Voroshilov str. 22A. Tel.: +73842396435.
Shamina, Inna V., PhD, assistant of the Department of Obstetrics and Gynecology №2, Omsk State Medical University Ministry of Health of Russia.
644043, Russia, Omsk, Lenin str. 12. Tel.: +73812240658. E-mail: innadocsever@rambler.ru
Tirskaya, Yuliya I., MD, professor of Obstetrics and Gynecology Department № 2, Omsk State Medical University Ministry of Health of Russia.
644043, Russia, Omsk, Lenin str. 12. Tel.: +73812240658. E-mail: akusheromsk@rambler.ru
Belinina, Antonina A., obstetrician-gynaecologist, Altay Regional Clinical Perinatal Center.
656045, Russia, Barnaul, Fomina str. 154. Tel.: +73852569311. E-mail: antonina_belinina@mail.ru
Lazareva, Oksana V., PhD, assistant of the Department of Obstetrics and Gynecology № 2, Omsk State Medical University Ministry of Health of Russia.
644043, Russia, Omsk, Lenin str. 12. Tel.: +73812240658. E-mail: lazow@mail.ru
Kadtsyna, Tatyana V., PhD, assistant of the Department of Obstetrics and Gynecology № 2, Omsk State Medical University Ministry of Health of Russia.
644043, Russia, Omsk, Lenin str. 12. Tel.: +73812240658.
Frickel, Ekaterina A., obstetrician-gynecologist of the Department of Reproductive and Perinatal Medicine of the Perinatal Center of BUZOO “Regional Clinical Hospital”. 644111, Russia, Omsk, Berezovaya str. 3. E-mail: kkrk@rambler.ru
Atamanenko, Olga Yu., obstetrician-gynecologist of the Department of Reproductive and Perinatal Medicine of the Perinatal Center of BUZOO “Regional Clinical Hospital”. 644111, Russia, Omsk, Berezovaya str. 3. E-mail: akusheromsk@rambler.ru
Ostrovskaya, Olga V., post-graduate student of the Department of Obstetrics and Gynecology № 2, Omsk State Medical University Ministry of Health of Russia.
644043, Russia, Omsk, Lenin str. 12. Tel.: +73812240658. E-mail: akusheromsk@rambler.ru
Stepanov, Sergey S., MD, senior laboratory assistant of the Department of Histology, Omsk State Medical University Ministry of Health of Russia.
644043, Russia, Omsk, Lenin str. 12. Tel.: +73812284133. E-mail: serg_stepanov@mail.ru
Beglov, Dmitry E., post-graduate student of the Department of Obstetrics and Gynecology №2, Kemerovo State Medical University.
650029, Russia, Kemerovo, Voroshilov str. 22A. Tel.:89030705000. E-mail: beglic@gmail.com

For citation: Barinov S.V., Artymuk N.V., Novikova O.N., Shamina I.V., Tirskaya Yu.I., Belinina A.A., Lazareva O.V., Kadtsyna T.V., Frikel E.A., Atamanenko O.Yu., Ostrovskaya O.V., Stepanov S.S., Beglov D.E. Experience in managing pregnant women at high risk for preterm birth, by using a dome-shaped obstetric pessary and cerclage. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (1): 140-48. (in Russian)
http: // dx.doi.org/10.18565/aig.2019.1.140-148

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