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CC BY 4.0 · Rev Bras Ginecol Obstet 2023; 45(12): e764-e769
DOI: 10.1055/s-0043-1776033
Original Article
High Risk Pregnancy

Arabin-pessary or McDonald Cerclage in Cervical Shortening?

Pessário de Arabin ou cerclagem McDonald no encurtamento cervical?
Aytaj Jafarzade 
1   Obstetrics and Gynecology Department, Koru Hospital Ankara, Ankara, Turkey.
,
Sveta Aghayeva 
1   Obstetrics and Gynecology Department, Koru Hospital Ankara, Ankara, Turkey.
,
Tamer Mungan 
1   Obstetrics and Gynecology Department, Koru Hospital Ankara, Ankara, Turkey.
,
Aydan Biri 
1   Obstetrics and Gynecology Department, Koru Hospital Ankara, Ankara, Turkey.
,
Osman Ufuk Ekiz 
2   Statistic Department, Gazi University, Yenimahalle, Ankara, Turkey.
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Abstract

Objective The aim of the present study is to compare the effectiveness of Arabin pessary and McDonald cervical cerclage on preterm delivery.

Methods We conducted a retrospective analysis of data from patients who underwent either Arabin pessary or McDonald cerclage between January 1, 2019, and January 1, 2023. A total of 174 patients were included in the study, with 31 undergoing Arabin pessary and 143 receiving cervical cerclage using the McDonald technique in singleton pregnant women with cervical insufficiency, which applied between 14 and 22 gestational weeks. We included singleton pregnant women with normal morphology, and with normal combined test. The primary outcome was the impact of each method on preterm delivery (< 34 gestational weeks).

Results The weeks of cervical cerclage or pessary application were compatible with each other (p < 0.680). The pessary group had a statistically significant longer time to delivery compared with the Cerclage group (cerclage group mean 30.8 c 7.1 standard deviation [SD] versus pessary group mean 35.1 ± 4.4 SD; p < 0.002). A statistically significant difference was found between the pessary and cerclage groups in terms of delivery at < 34 weeks (p = 0.002). In patients with cervical length between 25 and 15mm and < 15mm, no significant difference was found between the pessary and cerclage groups in terms of delivery week (p < 0.212; p < 0.149). Regardless of the technique applied, no statistically significant difference was observed between cervical length and birth < 34 weeks.

Conclusion Our study found that pessary use for cervical insufficiency is statistically more effective than cervical cerclage surgery in preventing preterm births < 34 weeks in singleton pregnancy.

Keywords

cerclage - pessary - cervical insufficiency - McDonald cerclage

Contributions

Jafarzade A.: Conception, design, writer, supervision, data collection, literature review. Aghayeva S.: Data collection and/or processing. Munga T.: Critical review. Biri A.: Critical review. Ekiz O. U.: Analysis and/or interpretation.




Publication History

Received: 27 April 2023

Accepted: 24 July 2023

Article published online:
23 December 2023

© 2023. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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