Vaginal pessary sharpens uterocervical angle in uterine prolapse during pregnancy. A case report.
cervical length
pregnancy
uterine prolapse
uterocervical angle
vaginal pessary
Journal
The journal of obstetrics and gynaecology research
ISSN: 1447-0756
Titre abrégé: J Obstet Gynaecol Res
Pays: Australia
ID NLM: 9612761
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
revised:
30
08
2021
received:
28
05
2021
accepted:
12
10
2021
pubmed:
28
10
2021
medline:
5
1
2022
entrez:
27
10
2021
Statut:
ppublish
Résumé
A 37-year-old multiparous woman complained of uterine prolapse at 14 weeks of gestation. A silicone ring-shaped middle-size vaginal pessary (# 62 mm) was placed into the vagina to reduce prolapsed uterus. Because the cervical length became shortened at 25 weeks of gestation, we decided to start intramuscular administration of progesterone (250 mg) weekly. At 33 weeks of gestation, she complained of the vaginal pessary spontaneous falling out, so we inserted a vaginal pessary of the same size again. The uterocervical angle became acute, going from 100° to 60° after placing the vaginal pessary into the vagina. We took the vaginal pessary out at 37 weeks of gestation. The patient gave birth at 39 weeks by spontaneous vaginal delivery to a healthy baby. A vaginal pessary may help continue a pregnancy via the same mechanism as a cervical pessary, which sharpens the uterocervical angle.
Substances chimiques
Progesterone
4G7DS2Q64Y
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
271-274Informations de copyright
© 2021 Japan Society of Obstetrics and Gynecology.
Références
Mohamed-Suphan N, Ng RKW. Uterine prolapse complicating pregnancy and labor: a case report and literature review. Int Urogynecol J. 2012 May;23(5):647-50.
Büyükbayrak EE, Yılmazer G, Özyapı AG, et al. Successful treatment of uterine prolapse during pregnancy with vaginal pessary: a case report. J Turk Ger Gynecol Assoc. 2010;11(2):105-6.
Zeng C, Yang F, Wu C, Zhu J, Guan X, Liu J. Uterine prolapse in pregnancy: two cases report and literature review. Case RepObstetr Gynecol. 2018;2018(2):1-5. https://doi.org/10.1155/2018/1805153
Brown HL. Cervical prolapse complicating pregnancy. J Natl Med Assoc. 1997;89(5):346-8.
Tsikouras P, Dafopoulos A, Vrachnis N, Iliodromiti Z, Bouchlariotou S, Pinidis P, et al. Uterine prolapse in pregnancy: risk factors, complications and management. J Matern Fetal Neonatal Med. 2014;27:297-302.
Daskalakis G, Lymberopoulos E, Anastasakis E, Kalmantis K, Athanasaki A, Manoli A, et al. Uterine prolapse complicating pregnancy. Arch Gynecol Obstet. 2007;276:391-2.
Fonseca EB, Celik E, Parra M, Singh M, Nicolaides KH, Fetal Medicine Foundation Second Trimester Screening Group. Progesterone and the risk of preterm birth among women with a short cervix. N Engl J Med. 2007;357:462-9.
Matsumoto T, Nishi M, Yokota M, Ito M. Laparoscopic treatment of uterine prolapse during pregnancy. Obstet Gynecol. 1999;93:849.
Dziadosz M, Bennett TA, Dolin C, West Honart A, Pham A, Lee SS, et al. Uterocevical angle: a novel ultrasound screening tool to predict spontaneous preterm birth. Am J Obstet Gynecol. 2016;215(3):376e1-7.
Cannie MM, Dobrescu O, Gucciardo L, Strizek B, Ziane S, Sakkas E, et al. Arabin cervical pessary in women at high risk of preterm birth: a magnetic resonance imaging observational follow-up study. Ultrasound Obstet Gynecol. 2013;42:426-33.
Pacagnella RC, Mol BW, Borovac-Pinheiro A, et al. A randomized controlled trial on the use of pessary plus progesterone to prevent preterm birth in women with short cervical length (P5 trial). BMC Pregnancy Childbirth. 2019;19:442. https://doi.org/10.1186/s12884-019-2513-2