Effectiveness of short cervix correction in women at risk
Talshyn Ukybassova (KZ), Aizada Marat (KZ)
[Ukybassova] CFB “UMC” "National Research Center of Maternity and Childhood", [Marat] JSC "Astana Medical University"
Relevance.The incidence of preterm delivery was 6.4% according to official data in the Republic of Kazakhstan. Objective.To evaluate the effectiveness of preventative methods of preterm delivery with a short cervix. Materials and methods.There were two groups based on the method of short cervix correction: I-32 patients who were treated with obstetric pessary Arabin combined with micronized progesterone at a dose of 300 mg/day intravaginally (Luteina,"Adamed") from the time of diagnosis of cervical shortening and up to 34 weeks of pregnancy, II-30 patients who had surgical cerclage in combination with micronized progesterone 200-300 mg intravaginally after cerclage and up to 34 weeks. 59 out of 62 pregnant women (90.3%) had a history of miscarriage: 39 (63%) had 2 or more spontaneous abortion at 18-21 weeks, 23(37%) previously had premature birth. Results.28 women (87.5%) in the main group delivered at term. 4 women delivered prematurely (12.5%) at the 34 and 33 weeks of gestation. In the group of surgical cerclage combined with micronized progesterone 24 out of 30 pregnant women delivered at term (80%); In 6 cases (20%), corrective cervical stitches were removed at 31-34 weeks due to onset of labour and/or preterm rupture of membranes. Conclusion.The effectiveness of methods of prevention of preterm birth in I group it was 87.5%, in II group it was 80%. A significant advantage of obstetric pessary is the absence of surgical aggression, invasive interventions, anesthesia and patient’s fear of the procedure; the possibility of outpatient care, the possibility of use at the later stages of pregnancy.