Objective: This study aimed to evaluate the effects of combined management of placenta previa with the Arabin cervical pessary and progesterone. Study design: In this randomized controlled study, we followed up 217 patients with placenta previa and high risk of preterm birth. The main group (n = 81) underwent combined management with the Arabin cervical pessary and progesterone; the control group (n = 136) received progesterone only. Placental migration was monitored using Doppler scanning from 24 weeks of pregnancy onwards. Results: Patients receiving the combination of the Arabin cervical pessary and progesterone had a three-fold reduced rate of bleeding during pregnancy compared with patients in the control group (11.3% versus 33.1%; p =.006). Placental migration occurred 1.8 times more often in the pessary group (48.1% versus 26.4%; p =.037), and preterm labor <34 weeks occurred 2.7 times less often compared with the control group (p =.031). The use of the Arabin cervical pessary caused a change in the anterior cervico-uterine angle by 7.4 degrees, and reduction in the arcuate artery RI at 32−33 weeks of pregnancy compared with the control group. Conclusions: The use of the Arabin cervical pessary combined with progesterone in patients with placenta previa significantly reduced the rate of preterm delivery <34 weeks and bleeding during pregnancy.
The role of cervical pessary and progesterone therapy in the phenomenon of placenta previa migration
Di Renzo G. C.;
2020
Abstract
Objective: This study aimed to evaluate the effects of combined management of placenta previa with the Arabin cervical pessary and progesterone. Study design: In this randomized controlled study, we followed up 217 patients with placenta previa and high risk of preterm birth. The main group (n = 81) underwent combined management with the Arabin cervical pessary and progesterone; the control group (n = 136) received progesterone only. Placental migration was monitored using Doppler scanning from 24 weeks of pregnancy onwards. Results: Patients receiving the combination of the Arabin cervical pessary and progesterone had a three-fold reduced rate of bleeding during pregnancy compared with patients in the control group (11.3% versus 33.1%; p =.006). Placental migration occurred 1.8 times more often in the pessary group (48.1% versus 26.4%; p =.037), and preterm labor <34 weeks occurred 2.7 times less often compared with the control group (p =.031). The use of the Arabin cervical pessary caused a change in the anterior cervico-uterine angle by 7.4 degrees, and reduction in the arcuate artery RI at 32−33 weeks of pregnancy compared with the control group. Conclusions: The use of the Arabin cervical pessary combined with progesterone in patients with placenta previa significantly reduced the rate of preterm delivery <34 weeks and bleeding during pregnancy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
