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Pessaries

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https://www.readbyqxmd.com/read/29103351/cervical-pessary-for-preventing-preterm-birth-a-meta-analysis
#1
Zhen Jin, Liqin Chen, Dongyan Qiao, Chhavi, Astha, Baiyun Sun, Lina Wang, Hong Yu
OBJECTIVE: To evaluate the efficacy of cervical pessary in the prevention of preterm birth and its influence on pregnancy and maternal outcomes, so as to provide a clinical basis for cervical pessary to prevent premature delivery. METHOD: The databases of PubMed, Web of Science, CNKI, WanFang Data, etc, were used to search for the eligible articles. The relevant data were abstracted by two independent reviewers and performed with Stata 12.0. RESULT: Pregnancy Result: the PTB rates of pessary and control group before 28, 32, 34 and 37 weeks were analyzed and the combined RR (95%CI) values were 0...
November 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29058493/induction-of-labour-clinical-predictive-factors-for-success-and-failure
#2
Laura Batinelli, Andrea Serafini, Nicola Nante, Felice Petraglia, Filiberto Maria Severi, Gabriele Messina
Induction of labour (IOL) is a widely-used practice in obstetrics. Our aim was to evaluate predictors of vaginal delivery in postdate pregnancies induced with prostaglandins. We conducted a retrospective cross-sectional study with analytic component. A total of 145 women, admitted for IOL after the 41st week of gestation, were induced with a vaginal pessary releasing prostaglandins. Type of delivery, whether vaginal or caesarean, was the outcome. Several maternal and foetal variables were investigated. The Kaplan-Maier curves, monovariate and a multivariate logistic regression were carried out...
October 23, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29055173/safety-and-efficacy-of-the-cervical-pessary-combined-with-vaginal-progesterone-for-the-prevention-of-spontaneous-preterm-birth
#3
Georgios Daskalakis, Dimitrios Zacharakis, Marianna Theodora, Panagiotis Antsaklis, Nikolaos Papantoniou, Dimitris Loutradis, Aris Antsaklis
INTRODUCTION: The aim of this study was to evaluate the safety and efficacy of the combined treatment of cervical pessary and endovaginal progesterone for the prevention of spontaneous preterm birth (SPB) in women with a short cervical length (CL) between 20 and 24 weeks of gestation. MATERIALS AND METHODS: This is a prospective study of women with a singleton pregnancy and a sonographically detected mid-trimester CL ≤25 mm. The primary outcome measure was spontaneous delivery before 34 weeks (238 days) of gestation...
October 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29049052/a-cost-utility-analysis-of-nonsurgical-treatments-for-stress-urinary-incontinence-in-women
#4
Andrea N Simpson, Alaina Garbens, Fahima Dossa, Peter C Coyte, Nancy N Baxter, Colleen D McDermott
OBJECTIVE: The objective of this study was to perform a cost-utility analysis of nonsurgical treatments for stress urinary incontinence (SUI) in healthy adult women with a health system perspective over a 1-year time horizon. METHODS: A decision tree model was constructed to evaluate the following nonsurgical treatment options for SUI in a simulated healthy adult female cohort who had failed Kegel exercises: pelvic floor muscle therapy (PFMT), a disposable tampon device (Impressa), a self-fitting intravaginal incontinence device (Uresta), and a traditional incontinence pessary...
October 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29033106/current-options-for-mechanical-prevention-of-preterm-birth
#5
REVIEW
Rupsa C Boelig, Vincenzo Berghella
Cervical insufficiency can be defined by a combination of obstetric history, cervical dilation on exam, and/or short cervical length in women with prior preterm birth. Options for mechanical intervention include cerclage and pessary. There is evidence to support the benefit of a cervical cerclage in women with singleton gestations who have a diagnosis of cervical insufficiency either based on second trimester painless cervical dilatation leading to recurrent early preterm births, or a history of early spontaneous preterm birth and a second trimester transvaginal ultrasound short cervical length or cervical dilation on exam...
October 12, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28988725/prevention-of-preterm-birth-novel-interventions-for-the-cervix
#6
REVIEW
Bouchra Koullali, Andrea R Westervelt, Kristin M Myers, Michael D House
Preterm birth is the leading cause of neonatal mortality and morbidity worldwide. Spontaneous preterm birth is a complex, multifactorial condition in which cervical dysfunction plays an important role in some women. Current treatment options for cervical dysfunction include cerclage and supplemental progesterone. In addition, cervical pessary is being studied in research protocols. However, cerclage, supplemental progesterone and cervical pessary have well known limitations and there is a strong need for alternate treatment options...
October 5, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28967060/original-flow-chart-for-the-management-of-hydroureteronephrosis-caused-by-pessary-placement
#7
Matteo Balzarro, Emanuele Rubilotta, Antonio B Porcaro, Nicolò Trabacchin, Antonio D'Amico, Maria Angela Cerruto, Walter Artibani
INTRODUCTION: The use of a pessary to treat a pelvic organ prolapse (POP) is a valid non-invasive option. Severe complications are usually associated with neglected, oversized, or misplaced pessaries. Major complications include fistulas, bowel or bladder erosion, and hydroureteronephrosis (HUN). MATERIALS AND METHODS: We reviewed the literature and our experience in the management of HUN in the last decade, as a consequence of pessary placement. RESULTS: We used flow charts to take an accurate medical history of each patient...
October 25, 2017: Urologia
https://www.readbyqxmd.com/read/28959181/bacterial-biota-of-women-with-bacterial-vaginosis-treated-with-lactoferrin-an-open-prospective-randomized-trial
#8
Alessandra Pino, Giuliana Giunta, Cinzia L Randazzo, Salvatore Caruso, Cinzia Caggia, Antonio Cianci
Background: Bacterial vaginosis is the most frequent condition associated to the vaginal microbiota imbalance, affecting about the 40-50% of women in the world. Even if antibiotics are effcetive for bacterial vaginosis treatment a long-term recurrence rates, higher than 70%, is recorded. Lactoferrin is an iron-binding glycoprotein with bacteriostatic and bactericidal properties. It owns the ability to protect the host against infection, by binding and regulating the iron needed for the bacterial proliferation...
2017: Microbial Ecology in Health and Disease
https://www.readbyqxmd.com/read/28949973/vaginal-progesterone-pessaries-for-pregnant-women-with-a-previous-preterm-birth-to-prevent-neonatal-respiratory-distress-syndrome-the-progress-study-a-multicentre-randomised-placebo-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Caroline A Crowther, Pat Ashwood, Andrew J McPhee, Vicki Flenady, Thach Tran, Jodie M Dodd, Jeffrey S Robinson
BACKGROUND: Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity. The withdrawal of progesterone, either actual or functional, is thought to be an antecedent to the onset of labour. There remains limited information on clinically relevant health outcomes as to whether vaginal progesterone may be of benefit for pregnant women with a history of a previous preterm birth, who are at high risk of a recurrence. Our primary aim was to assess whether the use of vaginal progesterone pessaries in women with a history of previous spontaneous preterm birth reduced the risk and severity of respiratory distress syndrome in their infants, with secondary aims of examining the effects on other neonatal morbidities and maternal health and assessing the adverse effects of treatment...
September 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28940481/prevention-of-preterm-birth-with-pessary-in-singletons-popps-a-randomized-controlled-trial
#10
Lorraine Dugoff, Vincenzo Berghella, Harish Sehdev, A Dhanya Mackeen, Laura Goetzl, Jack Ludmir
OBJECTIVE: To determine if pessary use prevents preterm birth in singleton gestations with a short transvaginal ultrasound cervical length and without a prior spontaneous preterm birth. METHODS: In this open-label multicenter randomized trial we enrolled asymptomatic women with singleton gestations with a transvaginal ultrasound cervical length ≤ 25 mm at 18(0) -23(6) weeks and no prior spontaneous preterm birth. Subjects were randomized to receive the Bioteque cup pessary or no pessary...
September 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28914070/effect-of-the-vaginal-pessaries-melanizol%C3%A2-and-klimedeks%C3%A2-on-the-glycogen-level-in-the-vaginal-tissue-of-rats-on-the-background-of-experimental-vaginitis
#11
Olena V Dolzhykova, Ludmyla M Maloshtan, Rimma F Yeriomenko, Volodymyr A Maloshtan
The experimental studies of the new vaginal pessaries Melanizol® and Klimedeks® have been carried out on the model of experimental vaginitis induced in rats by a mixture of terebenthine oil and dimethyl sulfoxide. The obtained experimental data indicate that the vaginal pessaries Melanizol® and Klimedeks® on the background of experimental vaginitis have a therapeutic effect on the 5th and 8th days of the experiment, significantly surpassing the group of animals of control pathology and placebo in its ability to restore physiological functions and accumulate glycogen by the vaginal epithelium...
2017: Ceská a Slovenská Farmacie
https://www.readbyqxmd.com/read/28903767/treatment-of-biofilms-in-bacterial-vaginosis-by-an-amphoteric-tenside-pessary-clinical-study-and-microbiota-analysis
#12
Cornelia Gottschick, Zhi-Luo Deng, Marius Vital, Clarissa Masur, Christoph Abels, Dietmar H Pieper, Manfred Rohde, Werner Mendling, Irene Wagner-Döbler
BACKGROUND: Bacterial vaginosis (BV) is the most common vaginal syndrome among women in their reproductive years. It is associated with an increased risk of acquiring sexually transmitted infections and complications like preterm labor. BV is characterized by a high recurrence rate for which biofilms frequently found on vaginal epithelial cells may be a reason. RESULTS: Here, we report a controlled randomized clinical trial that tested the safety and effectiveness of a newly developed pessary containing an amphoteric tenside (WO3191) to disrupt biofilms after metronidazole treatment of BV...
September 13, 2017: Microbiome
https://www.readbyqxmd.com/read/28889776/risk-of-spontaneous-preterm-birth-in-ivf-conceived-twin-pregnancies
#13
Gabriele Saccone, Fabrizio Zullo, Amanda Roman, Andrew Ward, Giuseppe Maruotti, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVE: To compare the mean transvaginal ultrasound (TVU) cervical length (CL) at midtrimester in screening for preterm birth in in vitro (IVF)-conceived twin pregnancies versus spontaneously-conceived twin pregnancies. METHODS: This was a retrospective cohort study. Potential study subjects were identified at the time of a routine second trimester fetal ultrasound exam at 18 0/7 to 23 6/7-week gestation. All women with twin diamniotic pregnancies screened with a single TVU CL for this trial were included...
September 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28871426/assessment-of-overactive-bladder-symptoms-among-women-with-successful-pessary-placement
#14
Dimitrios Zacharakis, Themos Grigoriadis, Eleni Pitsouni, Kostas Kypriotis, Nikistratos Vogiatzis, Stavros Athanasiou
INTRODUCTION AND HYPOTHESIS: The causal association between pelvic organ prolapse (POP) and overactive bladder (OAB) symptoms is supported by several theories. The aim of this study is to assess any changes in OAB symptoms among women with POP and OAB after successful pessary placement. METHODS: During the study period, all women with symptomatic POP stage II or greater and OAB symptoms were offered the solution of either a ring or a Gellhorn pessary. All patients were asked to complete a 3-day micturition/incontinence diary...
September 4, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28870155/pessary-or-progesterone-to-prevent-preterm-delivery-in-women-with-short-cervical-length-the-quadruple-p-randomised-controlled-trial
#15
Maud D van Zijl, Bouchra Koullali, Christiana A Naaktgeboren, Ewoud Schuit, Dick J Bekedam, Etelka Moll, Martijn A Oudijk, Wilhelmina M van Baal, Marjon A de Boer, Henricus Visser, Joris van Drongelen, Flip W van de Made, Karlijn C Vollebregt, Moira A Muller, Mireille N Bekker, Jozien T J Brons, Marieke Sueters, Josje Langenveld, Maureen T Franssen, Nico W Schuitemaker, Erik van Beek, Hubertina C J Scheepers, Karin de Boer, Eveline M Tepe, Anjoke J M Huisjes, Angelo B Hooker, Evelyn C J Verheijen, Dimitri N Papatsonis, Ben Willem J Mol, Brenda M Kazemier, Eva Pajkrt
BACKGROUND: Preterm birth is in quantity and in severity the most important topic in obstetric care in the developed world. Progestogens and cervical pessaries have been studied as potential preventive treatments with conflicting results. So far, no study has compared both treatments. METHODS/DESIGN: The Quadruple P study aims to compare the efficacy of vaginal progesterone and cervical pessary in the prevention of adverse perinatal outcome associated with preterm birth in asymptomatic women with a short cervix, in singleton and multiple pregnancies separately...
September 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28833951/attitudes-toward-pessary-use-among-thai-women-with-pelvic-organ-prolapse
#16
Treewijit Mungpooklang, Suvit Bunyavejchevin
AIM: This study was conducted to investigate attitudes toward pessary use in Thai women with pelvic organ prolapse (POP). METHODS: Ninety Thai women with symptomatic POP without any history of previous prolapse treatment were recruited. Participants completed a questionnaire about attitudes toward pessary use in Thai language. Patient characteristics and decision-making factors were identified. RESULTS: Forty eight women (53.3%) decided to use a pessary...
September 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28822628/retrospective-cohort-study-of-cervical-pessary-use-in-women-with-short-cervix-at-risk-of-preterm-delivery
#17
Laura Karis Allen, Jane Schulz, Catherine Flood, Sue Ross, Kentia Naud
OBJECTIVE: A paucity of effective interventions exists for the prevention of preterm birth (PTB). Renewed interest has focused on cervical pessaries, which have the benefits of being inexpensive, nonsurgical, and easily inserted and removed. In this study, we aim to describe our experience with this device in a Canadian tertiary care centre. Primary outcomes were rates of spontaneous or iatrogenic PTB before 37, 34, and 28 weeks gestation in pregnancies complicated by short cervix treated with cervical pessary...
August 16, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28815277/discontinuation-rate-and-adverse-events-after-1%C3%A2-year-of-vaginal-pessary-use-in-women-with-pelvic-organ-prolapse
#18
Theerarat Yimphong, Teerayut Temtanakitpaisan, Pranom Buppasiri, Chompilas Chongsomchai, Supparaluck Kanchaiyaphum
INTRODUCTION AND HYPOTHESIS: To ascertain the rate of discontinuation after vaginal pessary use among pelvic organ prolapse patients. METHODS: We enrolled women suffering from pelvic organ prolapse who opted to use vaginal pessary as the first line of treatment and were fitted with a pessary at the urogynecological clinic in Khon Kaen University's Srinagarind Hospital (Thailand) during the period between 2010 and 2016. Patients' medical records were retrospectively reviewed...
August 16, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28797120/medication-eluting-devices-for-the-field-of-obgyn-medobgyn-3d-printed-biodegradable-hormone-eluting-constructs-a-proof-of-concept-study
#19
Karthik Tappa, Udayabhanu Jammalamadaka, David H Ballard, Todd Bruno, Marissa R Israel, Harika Vemula, J Mark Meacham, David K Mills, Pamela K Woodard, Jeffery A Weisman
3D printing has the potential to deliver personalized implants and devices for obstetric and gynecologic applications. The aim of this study is to engineer customizable and biodegradable 3D printed implant materials that can elute estrogen and/or progesterone. All 3D constructs were printed using polycaprolactone (PCL) biodegradable polymer laden with estrogen or progesterone and were subjected to hormone-release profile studies using ELISA kits. Material thermal properties were tested using thermogravimetric analysis and differential scanning calorimetry...
2017: PloS One
https://www.readbyqxmd.com/read/28777192/sexual-function-after-prolapse-repair
#20
Abigail Shatkin-Margolis, Rachel N Pauls
PURPOSE OF REVIEW: The purpose of this review is to summarize available literature (from the last 18 months) assessing sexual function following pelvic reconstructive surgery for pelvic organ prolapse (POP). We include vaginal native tissue repair, abdominal/laparoscopic sacrocolpopexy, transvaginal mesh repair, and obliterative procedures. The goal is to assist providers in counseling patients and to identify areas needed for further research. RECENT FINDINGS: When compared with pessary management, women who undergo POP surgical repair achieve their sexual function goals more often...
October 2017: Current Opinion in Obstetrics & Gynecology
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