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Int. J. Environ. Res. Public Health 2018, 15(4), 791; https://doi.org/10.3390/ijerph15040791

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

1
Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
2
Medical Informatics Laboratory, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
3
Department of Obstetrics and Gynecology, Rea Hospital, 17564 Athens, Greece
4
Department of Obstetrics and Gynecology, Technological Educational Institute, 17564 Athens, Greece
5
Department of Obstetrics and Gynecology, Clinicum Aschaffenburg, Teaching Hospital of University, 97070 Würzburg, Germany
*
Author to whom correspondence should be addressed.
Received: 17 March 2018 / Revised: 11 April 2018 / Accepted: 12 April 2018 / Published: 18 April 2018
(This article belongs to the Special Issue IJERPH: 15th Anniversary)
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Abstract

Objective: 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. Material and methods: 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. Results: 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. Conclusion: 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. View Full-Text
Keywords: cervical Arabin pessary; cerclage; second trimester of pregnancy cervical Arabin pessary; cerclage; second trimester of pregnancy
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Tsikouras, P.; Anastasopoulos, G.; Maroulis, V.; Bothou, A.; Chalkidou, A.; Deuteraiou, D.; Anthoulaki, X.; Tsatsaris, G.; Bourazan, A.H.; Iatrakis, G.; Zervoudis, S.; Galazios, G.; Inagamova, L.-K.; Csorba, R.; Teichmann, A.-T. Comparative Evaluation of Arabin Pessary and Cervical Cerclage for the Prevention of Preterm Labor in Asymptomatic Women with High Risk Factors. Int. J. Environ. Res. Public Health 2018, 15, 791.

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