Table 1.
Prospective cohort studies.
| Author | Year | Country | No. of women | Inclusion criteria | Exclusion criteria | Age | Type of pessary | Pregnancy outcome | Neonatal outcome | Pessary removal and side effects |
|---|---|---|---|---|---|---|---|---|---|---|
| Quaas | 1990 | Germany | 107 |
Women with history of miscarriages Preterm birth, multiple pregnancies, Cervical conization, cervical tear, cervical Ripening (bishop score >6), dilation or Prolapsed membranes |
Not clearly stated | Not stated | Arabin | 92% of women treated with pessary delivered >36 weeks | Not stated | 36 weeks of gestation |
|
| ||||||||||
| Arabin | 2003 | The Netherlands | 11 | History of spontaneous preterm birth <36 weeks and a CL <15 mm (singletons and twins) | Severe regular contractions Blood loss Premature rupture of membranes |
24–43 years | Arabin |
Singletons: mean GA at delivery 35 + 3 weeks Twins: mean GA at delivery 35 weeks Pessary versus control: singletons <28 weeks: 0 (0%) versus 2 (17%) <32 weeks: 0 (0%) versus 3 (25%) <36 weeks: 0 (0%) versus 6 (50%) Pessary versus control: twins <28 weeks: 0 (0%) versus 1 (4%) <32 weeks: 0 (0%) versus 7 (30%) <36 weeks: 8 (35%) versus 12 (52%) |
Not stated | 17 (58%) complains of discharge 13 (44%) pain during insertion 15 (52%) pain during removal 28 (97%) recommend to others |
|
| ||||||||||
| Antczak-Judycka | 2003 | Poland | 57 | Women with a risk of PTB: shortening of cervical length or dilatation between 22–27 weeks |
Intrauterine infection contractions Urine tract infection Vaginal infection |
20–46 | Not defined |
Cerclage versus pessary Prolongation of pregnancy: 13.4 (±3 weeks) versus 12.1 (±3 weeks) Mean GA at delivery: 37.3 (±2 weeks) versus 37.7 (±3 weeks) Delivery >37 weeks: 17 (77%) versus 31 (89%) |
Cerclage versus pessary birthweight: 3080 ± 676 versus 3063 ± 826 Apgar score 5 min: “good” perinatal death: 2 (6%) pessary group |
Cerclage versus pessary PPROM: 1 (5%) versus 2 (6%) Premature contractions: 2 (10%) versus 2 (6%) Cervical tear: 3 (15%) cerclage group Pessary dislocation: 1 (3%) |
|
| ||||||||||
| Acharya | 2006 | Norway | 32 (21 singletons, 9 twins, 2 triplet) | Women with a riskfactor for PTB and a short CL (<25 mm) before 30 weeks of GA | No viable fetus or congenital malformations | 23–39 years | Arabin | Delivery <28 weeks: 6 (20.7%) Delivery <34 weeks: 13 (45%) Mean GA at delivery 34 weeks |
Mean birthweight: 2255 g Mean Apgar score at 5 min: 8 Perinatal death: 4 (14%) |
34 + 36 weeks 2 removal due to pain Increased discharge in all women |
|
| ||||||||||
| Sieroszewski | 2009 | Poland | 54 | Singleton pregnancies with a CL 15–30 mm before 28 weeks |
Multiple pregnancies Fetal malformations Uterine contractions PPROM Blood loss Abnormal placenta localisation |
<20 years 1 (1.9%) 20–34 years 47 (87%) 35–39 years 4 (7.4%) >37 years 2 (3.7%) |
Arabin | Delivery <37 weeks: 9 (16.7%) Mean GA at delivery 35.3 weeks |
Apgar score scales: 0–4: 2 children (3.7%) 5–7: 7 (13%) 8–10: 45 (83.3%) NICU admission: 2 (39%) 0 neonatal deaths |
Mean gestational age at removal 33.3 weeks No complications or side effects |
|
| ||||||||||
| Kimber-Trojnar | 2010 | Poland | 56 | Women with a riskfactor for PTB: history miscarriages, prior PTB <34 weeks, cervical suture in previous pregnancy, history of cervical | Contractions, ruptured membranes, maternal pyrexia, elevated CRP or white blood cell count, vaginal | 19–43 years | Polyvinyl chloride pessary | Delivery <34 weeks: 2 (3.6%) Delivery 34–37 weeks: 6 (10.7%) Delivery >37 weeks: 48 (85.7%) |
Mean birthweigth: 3255 Mean Apgar score at 3 min: 9, 6 58 (100%) live born infants 7 (12.5%) NICU admission |
37 weeks, contractions vaginal bleeding, discomfort fetal distress, ruptured membranes |