Pessary, what it is and when it is used

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Pessary

Often, for some pregnant women at risk for preterm labor, we hear about pessary. But what exactly is this little-known tool? What is it for? Let's clarify about it.

In this article

• Pessary, what is it
• Pessary, what it is used for and how it is used
• Pessary, when removed

Pessary, what is it

The pessary is a non-invasive intravaginal device, generally made of silicone, which can be used in women with prematurely shortened cervix (18-22 weeks). This tool can be particularly useful for preventing preterm birth and is a potential alternative - simple and non-invasive - to cervical cerclage.

In women who are not pregnant, the pessary is used in case of pelvic organ prolapse. This happens when the bladder, rectum or uterus sags or swells, "moving" towards the vagina.

Read also: Cervical cerclage

Pessary, what it is used for and how it is used

The device, soft and removable, if inserted would act changing the angle between the cervix and uterus, thus decreasing both the pressure on the cervix and the contact between the membranes and the vaginal bacteria.

According to a Spanish study, the pessary would be even more useful in case of twin pregnancy and short cervix. In fact, if the pregnancy is twins, the risk of preterm birth is higher: in this case, interventions may be necessary to prevent premature birth, including the insertion of the pessary.

The insertion of the pessary takes place in such a way that the smaller diameter ring is directed towards the cervix, in order to completely surround it, while the anterior part of the pessary is gently pushed towards the sacrum. The correct positioning is verified with visit or transvaginal ultrasound.

Controindicazioni

The use of the pessary is contraindicated in case of:

• suspicion of chorionamniositis,
• lethal fetal anomaly,
• membranes that protrude outside the cervix,
• regular and painful contractions.

Read also: Exams in pregnancy

Pessary, when removed

The pessary must be removed around the 37th week or if the patient goes into labor.

In case of premature rupture of the membranes, the pessary can remain in place if the diagnosis of chorionamniositis has been ruled out and if there are no uterine contractions. 

Sources for this article: www.sigo.com; Ajog.org; Webmd.com; Pubmed.gov; NCBI 

Read also: Premature babies, 10 things to know

TAG:

• preterm birth
• threatens preterm birth
• preterm infant