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Cervical pessary in prevention of preterm birth: A case series

Erika Gail G. Hernandez, MD and Mary Anne Tabaquero, MD, FPOGS
Department of Obstetrics and Gynecology, St. Luke’s Medical Center, Quezon City

Preterm birth defined as birth between 20-37 weeks age of gestation, poses major concerns as it causes serious health problems. Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born and the Philippines ranks 8th out of 184 countries for the number of babies born prematurely, and ranks 17th for the total number of deaths due to complications from preterm birth. Management of incompetent cervix as one of the causes of preterm birth is cerclage. However, pessary insertion is an alternative especially in cases where cerclage may not be employed. To date, there have been no local published reports on effectiveness of pessary in prevention of preterm birth. Hence this study aims to report on cases supporting the use of pessary in preterm birth. This is a case series of three patients with short functional cervical lengths (<2.5 cm) seen in ultrasound, managed with pessary insertion showing its effectiveness in prolonging pregnancy. In conclusion, pessary is an affordable and safe alternative management of preterm birth which may be employed in our setting. Future clinical trials may be helpful in strengthening this evidence.