Prevention of Preterm Birth in Singleton and Twin Pregnancy by Using Arabin Obstetric Pessary

Background: Prevention of preterm births (PB) is a challenge for modern obstetrics. Often the only reliable predictor of threatening PB is untimely cervical ripening.

Objective: We aimed to evaluate the efficacy of Arabin obstetric pessary (AP) in singleton (SP) and twin pregnancies (TP) at untimely cervical ripening.

Methods: We studied 100 women with SP and 50 women with TP with cervical shortening at 18-32 weeks of gestation. The criteria for implementation of AP were cervical length ≤38 mm (<25‰) in TP and ≤25 in SP. All patients have had undergone transvaginal ultrasound cervimetry and vaginal microbiological examination. Prevention therapy for PB was complex and based on severity of symptoms. Pessary was prematurely removed in case of premature rupture of membranes or in the development of labor; or at 37 weeks of gestation in the absence of indications for early removal.

Results: The frequency of term births was 86% in SP and 52% in TP, PB comprised 14% in SP and 48% in TP. Interestingly, there was no PB

Conclusion: The use of AP in SP and TP allows to prolong pregnancy, reduce the incidence of preterm birth, and improve perinatal outcome.