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Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia

BACKGROUND: Spontaneous preterm birth is a global issue that contributed to perinatal morbidities and mortalities worldwide. The study aimed to describe the experience at UKM Medical Center in managing women at high risk for spontaneous preterm birth using the Arabin pessary. METHODS: This is a retr...

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Autores principales: Rahman, Rahana Abd, Atan, Ixora Kamisan, Ali, Anizah, Kalok, Aida Mohd, Ismail, Nor Azlin Mohamed, Mahdy, Zaleha Abdullah, Ahmad, Shuhaila
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108362/
https://www.ncbi.nlm.nih.gov/pubmed/33971828
http://dx.doi.org/10.1186/s12884-021-03838-x
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author Rahman, Rahana Abd
Atan, Ixora Kamisan
Ali, Anizah
Kalok, Aida Mohd
Ismail, Nor Azlin Mohamed
Mahdy, Zaleha Abdullah
Ahmad, Shuhaila
author_facet Rahman, Rahana Abd
Atan, Ixora Kamisan
Ali, Anizah
Kalok, Aida Mohd
Ismail, Nor Azlin Mohamed
Mahdy, Zaleha Abdullah
Ahmad, Shuhaila
author_sort Rahman, Rahana Abd
collection PubMed
description BACKGROUND: Spontaneous preterm birth is a global issue that contributed to perinatal morbidities and mortalities worldwide. The study aimed to describe the experience at UKM Medical Center in managing women at high risk for spontaneous preterm birth using the Arabin pessary. METHODS: This is a retrospective observational study involving 58 pregnancies from 1st January 2013 to 31st December 2019. Inclusion criteria were previous mid-trimester miscarriage and/or preterm birth, previous cervical surgery or short cervical length on routine sonogram. The demographic data, characteristics of each pregnancy and details of outcomes and management were described. RESULTS: The majority of women were Malay with mean age and body mass index of 32.9 ± 4.2 years and 27.1 ± 6.3 kg/m(2) respectively. The most frequent indications for Arabin pessary insertion were previous mid-trimester miscarriage (46.4%) and early preterm birth (17.2%). A total of 73.4% of these women had the pessary inserted electively at a mean cervical length of 31.6 ± 9.1 mm at median gestation of 15.0 weeks. They were managed as outpatient (56.9%), inpatient (24.1%) or mixed (19.0%) with combination of progestogen (81.0%) and 53.4% received antenatal corticosteroids. Spontaneous preterm birth at or more than 34 weeks gestation occurred in 74.1% with birthweight at or more than 2000 g (82.4%). Despite cervical funneling in 12 women (20.7%), 66.7% delivered at or later than 34 weeks gestation and 2 (16.7%) resulted in miscarriage. CONCLUSIONS: Insertion of the Arabin pessary is beneficial to prevent spontaneous preterm birth in pregnant women who are at high risk. In particular, early insertion and close monitoring allows the best possible outcomes. TRIAL REGISTRATION: This study was retrospectively registered with ClinicalTrials.gov (NCT04638023) on 20/11/2020.
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spelling pubmed-81083622021-05-11 Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia Rahman, Rahana Abd Atan, Ixora Kamisan Ali, Anizah Kalok, Aida Mohd Ismail, Nor Azlin Mohamed Mahdy, Zaleha Abdullah Ahmad, Shuhaila BMC Pregnancy Childbirth Research Article BACKGROUND: Spontaneous preterm birth is a global issue that contributed to perinatal morbidities and mortalities worldwide. The study aimed to describe the experience at UKM Medical Center in managing women at high risk for spontaneous preterm birth using the Arabin pessary. METHODS: This is a retrospective observational study involving 58 pregnancies from 1st January 2013 to 31st December 2019. Inclusion criteria were previous mid-trimester miscarriage and/or preterm birth, previous cervical surgery or short cervical length on routine sonogram. The demographic data, characteristics of each pregnancy and details of outcomes and management were described. RESULTS: The majority of women were Malay with mean age and body mass index of 32.9 ± 4.2 years and 27.1 ± 6.3 kg/m(2) respectively. The most frequent indications for Arabin pessary insertion were previous mid-trimester miscarriage (46.4%) and early preterm birth (17.2%). A total of 73.4% of these women had the pessary inserted electively at a mean cervical length of 31.6 ± 9.1 mm at median gestation of 15.0 weeks. They were managed as outpatient (56.9%), inpatient (24.1%) or mixed (19.0%) with combination of progestogen (81.0%) and 53.4% received antenatal corticosteroids. Spontaneous preterm birth at or more than 34 weeks gestation occurred in 74.1% with birthweight at or more than 2000 g (82.4%). Despite cervical funneling in 12 women (20.7%), 66.7% delivered at or later than 34 weeks gestation and 2 (16.7%) resulted in miscarriage. CONCLUSIONS: Insertion of the Arabin pessary is beneficial to prevent spontaneous preterm birth in pregnant women who are at high risk. In particular, early insertion and close monitoring allows the best possible outcomes. TRIAL REGISTRATION: This study was retrospectively registered with ClinicalTrials.gov (NCT04638023) on 20/11/2020. BioMed Central 2021-05-10 /pmc/articles/PMC8108362/ /pubmed/33971828 http://dx.doi.org/10.1186/s12884-021-03838-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Rahman, Rahana Abd
Atan, Ixora Kamisan
Ali, Anizah
Kalok, Aida Mohd
Ismail, Nor Azlin Mohamed
Mahdy, Zaleha Abdullah
Ahmad, Shuhaila
Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia
title Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia
title_full Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia
title_fullStr Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia
title_full_unstemmed Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia
title_short Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia
title_sort use of the arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in malaysia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108362/
https://www.ncbi.nlm.nih.gov/pubmed/33971828
http://dx.doi.org/10.1186/s12884-021-03838-x
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