Obstetric pessary - what is it? Women's comments on the application of pessaries

Another 50-40 years ago, pregnant women could lose a healthy fetus at the end of the first trimester of pregnancy or at the beginning of the second because of premature opening of the cervix. The fact is that in those days the only way to combat such a phenomenon was to sew the cervical canal, and since such an operation can be performed only under anesthesia, it had to be postponed to a later date. Fortunately, today such situations happen extremely rarely, because doctors use special devices - obstetric pessaries. They are not sold in pharmacies and they are not recommended to try to install independently.

Pessary: what is this

To denote the problems associated with premature opening of the cervix, the term "isthmico-cervical insufficiency" is used in medicine. To prevent its negative consequences, such as miscarriage, doctors often recommend installing a pessary unloading. The classical version of such a device, created with due regard for the anatomical features of the structure of the woman's body, is several plastic or silicone rings connected together.

Kinds

Obstetrical pessary, reviewed about at the end of the article, can be of several types. In particular, the pharmaceutical industry produces similar devices of three sizes:

• First . Such pessaries are suitable for women giving birth less than 2 times, as well as pregnant women with a length of the upper third of the vagina from 55 to 65 mm or with a diameter of the cervix from 25 to 30 mm.
• The second . Devices of this size are installed in pregnant women, which fall under the criteria corresponding to the first point, but the length of the upper third of the vagina in which - from 66 to 75 mm.
• Third size. These are the largest pessaries that obstetricians place repeatedly giving birth to mothers, as well as women whose length of the upper third of the vagina exceeds 76 mm or the diameter of the cervix varies in the range of 30-37 mm.

Surely many people think of the pessary, that this is one or more connected rings. However, there are many types of such a device of a completely different form. For example, pregnant women sometimes insert a cupped pessary designed to maintain the cervix, reduce the pressure of the fetal head on it and to prevent the opening of the uterine throat. In addition, with ischemic-cervical insufficiency, a device in the form of a bagel (thick ring) made of polyvinyl chloride can be installed. This material has the property of thermoplasticity and, being inside the body of a woman, becomes soft, taking the form of the organ into which it was placed. Also for the manufacture of pessary silicone is often used, which does not cause allergic reactions. Such devices are previously sterilized by gamma radiation.

In which cases are the

Obstetrical pessary during pregnancy is established in order to keep the uterus and adjacent internal organs in the correct position. And very often it is prescribed in the case of multiple pregnancies. In addition, pessaries of various types are also used to solve the health problems of non-pregnant women. In particular, they are effective in cases where it is necessary to prevent the loss of internal organs (uterus) or to alleviate the condition of a patient who has incontinence.

Contraindications and possible negative consequences

Although usually for all fears of pregnant obstetricians are responsible for the pessary, which is completely safe, there are cases when it is forbidden to put it. In particular, this can not be done if:

• There are suspicions of a frozen pregnancy;
• The lower part of the bladder is already in the vagina;
• Spotting and / or syphilis;
• Revealed inflammatory processes of the genital organs.

If such a device is selected or installed incorrectly or for some reason displaced, the pregnant woman may develop inflammation (colpitis), which can be eliminated by correcting the position of the pessary and applying medication.

How to put a pessary

Before such procedure it is necessary to undergo examination and, in case of revealing any infections of the organs of the urino-genital area, to deal with their cure. In addition, if the pregnant woman has an increased tone of the uterus, then 30-60 minutes before the installation of the ring, she is given an antispasmodic that removes contractions, and to reduce friction, use medical glycerine. Only after this you can put a pessary. That it is quite unpleasant, confirms any woman. However, sometimes this procedure is the only way to keep a pregnancy, especially in the early stages, when it is impossible to perform a surgical operation to sew the cervix.

When can I put

Most often, the pessary, reviews of which are mostly positive, are put after the 20th week of pregnancy. However, as already mentioned, sometimes, in connection with the threat of miscarriage, have to do it already at 12-14 weeks. At the same time, regardless of how many times the pregnant woman has already given birth, a ring of the first size is always used.

What you need and what you can not do after installing the pessary

After the accessory was fitted onto the cervix of the pregnant woman, the woman does not need to do anything special. The only thing that doctors recommend after installing the pessary - from time to time (1 time in 14-21 days) take a smear to study the bacteriological flora, and to prevent infection every 2-3 weeks to carry out vaginal treatment, and, of course, to refrain from Sex life. And the last advice a woman would have to follow, even if she had not put a ring. After all, when it comes to the advisability of such a procedure, this very fact indicates the existence of a threat of premature termination of pregnancy.

Childbirth

Usually the device we are considering is left until the 36-38th week of pregnancy. Then the gynecologist is made out of the pessary in an outpatient or in a hospital. This procedure is done without anesthesia, but lasts only a few seconds, so the pain, if any, is extremely short. Sometimes it is done in a hospital, in the department of pathology, and sometimes out-patiently, at a gynecologist's appointment. Removal of the pessary leads to the fact that the cervix relaxes, and under the pressure of the fetus, its softening very soon takes place, followed by shortening and opening. After that, somewhere within a week (sometimes this period may be a little more), a woman begins labor. However, there are situations when this device must be removed ahead of schedule. For example, it is necessary to do this if there is a discharge of amniotic fluid, a fetal bladder is infected, or emergency delivery is necessary.

Obstetrical pessary: reviews

Today, the installation of such devices is quite common. Therefore, regarding their effectiveness and problems associated with the use of pessaries, you can hear a lot of comments. In particular, women complain about the unpleasant feelings that they have when you have to make long trips by car or just sit in a sitting position for a long time. In addition, there is also a worsening of the smear analysis, which is caused by the pessary. The reviews also show that the procedures for its installation and removal can give women quite considerable pain. But the most unpleasant, in the opinion of pregnant women who have such a protective obstetric device, is a sharp increase in the amount of secretions 3-4 weeks after the insertion of the pessary, which is connected with the desire of the body to get rid of the foreign body. Some patients even say that there may be so many of them that there are suspicions about the outflow of amniotic fluid and one must constantly wear gaskets.

Now you know what an obstetric pessary is, you might have heard about it from friends and acquaintances. In any case, we can say with certainty that at the moment there are no cases when the use of the said medical device would cause serious health problems - neither before the birth nor after. However, doctors warn that even with the pessaries installed, sometimes (although very rarely) miscarriage can occur. At the same time, statistics show that after the use of such devices in the early stages of Isthmiko-cervical insufficiency, the number of positive outcomes of pregnancies has increased significantly.