Cervical pessary

The cervical pessary is a silicone ring placed around the cervix of the pregnant woman, which can reduce the risk of prematurity in pregnant women with a short cervix.

It was introduced to prevent preterm birth by Dr Arabin in 2003. Our group is a pioneer and has led the use of the cervical pessary for the prevention of preterm birth after the publication of the first clinical trial comparing the pessary vs Usual management in asymptomatic pregnant women with a short cervix in The Lancet magazine in 2012 (11). Subsequently, he has published different works about the use of the pessary in other populations of pregnant women, as well as the importance of unifying criteria in the publications on preterm birth in general (similar variables) and pessary in particular (1-12).

Contact for training workshop: mgoya@vhebron.net

Although the pessary is an inexpensive and easy-to-use treatment, health professionals must be trained in its placement and the management of patients with pessaries, as some studies have already shown (**).

For all these reasons, our team has prepared a specific and personalised training workshop for training and skills in cervical pessaries. If you are interested, don’t hesitate to get in touch with us: mgoya@vhebron.net.

 

REFERENCES

*Arabin B, Halbesma JR, Vork F, Hübener M, van Eyck J. Is treatment with vaginal pessaries an option in patients with a sonographically detected short cervix? J Perinat Med. 2003;31(2):122-33. doi: 10.1515/JPM.2003.017. PMID: 12747228.

**França MS, Hatanaka AR, Cruz JJ, Andrade Júnior VL, Kawanami Hamamoto TE, Sarmento SGP, Elito Júnior J, Pares DBDS, Mattar R, Araujo Júnior E, Moron AF. Cervical pessary plus vaginal progesterone in a singleton pregnancy with a short cervix: an experience-based analysis of cervical pessary’s efficacy. J Matern Fetal Neonatal Med. 2021 May 2:1-11. doi: 10.1080/14767058.2021.1919076. Epub ahead of print. PMID: 33938351.

1. Prediction of preterm birth and adverse perinatal outcomes after cervical pessary placement in singleton pregnancies with short cervical length. Mendoza M, Maiz N, Garcia-Ruiz I, Vargas M, Rodo C, Goya M, Carreras E. J Matern Fetal Neonatal Med. 2021 Oct;34(19):3147-3153. doi: 10.1080/14767058.2019.1678137. Epub 2019 Oct 23. PMID: 31640496
2. Cervical modifications after pessary placement in singleton pregnancies with maternal short cervical length: 2D and 3D ultrasound evaluation. Mendoza Cobaleda M, Ribera I, Maiz N, Goya M, Carreras E. Acta Obstet Gynecol Scand. 2019 Nov;98(11):1442-1449. doi: 10.1111/aogs.13647. Epub 2019 Jun 13. PMID: 31102541
3. Should phenotype of previous preterm birth influence management of women with short cervix in subsequent pregnancy? Comparison of vaginal progesterone and Arabin pessary. Care A, Muller-Myhsok B, Olearo E, Todros T, Caradeux J, Goya M, Palacio M, Carreras E, Alfirevic Z. Ultrasound Obstet Gynecol. 2019 Apr;53(4):529-534. doi: 10.1002/uog.19118. PMID: 29920812
4. Cervical pessary to reduce preterm birth <34 weeks of gestation after an episode of preterm labor and a short cervix: a randomized controlled trial. Pratcorona L, Goya M, Merced C, Rodó C, Llurba E, Higueras T, Cabero L, Carreras E; Trial Group. Am J Obstet Gynecol. 2018 Jul;219(1):99.e1-99.e16. doi: 10.1016/j.ajog.2018.04.031. Epub 2018 Apr 25. PMID: 29704487 Clinical Trial.
5. Prevention of spontaneous preterm birth. Daskalakis G, Goya M, Pergialiotis V, Cabero L, Kyvernitakis I, Antsaklis A, Arabin B. Arch Gynecol Obstet. 2019 May;299(5):1261-1273. doi: 10.1007/s00404-019-05095-y. Epub 2019 Feb 14. PMID: 30761417 Review.
6. Modification of cervical length after cervical pessary insertion: correlation weeks of gestation. Mendoza M, Goya M, Gascón A, Pratcorona L, Merced C, Rodó C, Valle L, Romero A, Juan M, Rodríguez A, Muñoz B, Santacruz BN, Carreras E, Cabero L. J Matern Fetal Neonatal Med. 2017 Jul;30(13):1596-1601. doi: 10.1080/14767058.2016.1216538. Epub 2016 Aug 28. PMID: 27568682 Clinical Trial.
7. Cervical pessary to prevent preterm birth in women with twin gestation and sonographic short cervix: a multicenter randomized controlled trial (PECEP-Twins). Goya M, de la Calle M, Pratcorona L, Merced C, Rodó C, Muñoz B, Juan M, Serrano A, Llurba E, Higueras T, Carreras E, Cabero L; PECEP-Twins Trial Group. Am J Obstet Gynecol. 2016 Feb;214(2):145-152. doi: 10.1016/j.ajog.2015.11.012. Epub 2015 Nov 25. PMID: 26627728 Clinical Trial.
8. Cervical pessary for preventing preterm birth in twin pregnancies with maternal short cervix after an episode of threatened preterm labor: randomised controlled trial.
Merced C, Goya M, Pratcorona L, Rodó C, Llurba E, Higueras T, Cabero L, Carreras E; PECEP-RETARD Trial Group. Am J Obstet Gynecol. 2019 Jul;221(1):55.e1-55.e14. doi: 10.1016/j.ajog.2019.02.035. Epub 2019 Feb 28. PMID: 30826339 Clinical Trial.
9. Vaginal progesterone, cerclage or cervical pessary for preventing preterm birth in asymptomatic singleton pregnant women with a history of preterm birth and a sonographic short cervix.
Alfirevic Z, Owen J, Carreras Moratonas E, Sharp AN, Szychowski JM, Goya M. Ultrasound Obstet Gynecol. 2013 Feb;41(2):146-51. doi: 10.1002/uog.12300. Epub 2013 Jan 17. PMID: 22991337 Clinical Trial.
10. Sonographic cervical length measurement in pregnant women with a cervical pessary. Goya M, Pratcorona L, Higueras T, Perez-Hoyos S, Carreras E, Cabero L. Ultrasound Obstet Gynecol. 2011 Aug;38(2):205-9. doi: 10.1002/uog.8960. Epub 2011 Jul 18. PMID: 21305638
11. Cervical pessary in pregnant women with a short cervix (PECEP): an open-label randomised controlled trial. Goya M, Pratcorona L, Merced C, Rodó C, Valle L, Romero A, Juan M, Rodríguez A, Muñoz B, Santacruz B, Bello-Muñoz JC, Llurba E, Higueras T, Cabero L, Carreras E; Pesario Cervical para Evitar Prematuridad (PECEP) Trial Group. Lancet. 2012 May 12;379(9828):1800-6. doi: 10.1016/S0140-6736(12)60030-0. Epub 2012 Apr 3. PMID: 22475493 Clinical Trial.
12. Arabin cervical pessary to prevent preterm birth in severe twin-to-twin transfusion syndrome treated by laser surgery. Carreras E, Arévalo S, Bello-Muñoz JC, Goya M, Rodó C, Sanchez-Duran MA, Peiro JL, Cabero L. Prenat Diagn. 2012 Dec;32(12):1181-5. doi: 10.1002/pd.3982. Epub 2012 Oct 11.