Not all women have a pregnancy that runs smoothly and without complications. Some future mothers face the problem of too early disclosure of the cervix. In such situations, many women are offered a pessary to maintain their pregnancy.
Obstetric pessary is a special plastic device used in pregnancy to support the uterus, rectum and bladder, in the form of different diameters of rings that are connected together. The edges of the rings are perfectly smooth, so that it does not injure the tissues. There are several sizes of pessaries. In each case, the size is chosen by the doctor, taking into account factors such as the size of the vagina, the diameter of the cervix, the number of births.
Installation of pessaries during pregnancy is an alternative to sewing the cervix. Since the cervix can be sewn only under anesthesia, which adversely affects the health of the baby, the pessary becomes the best option for maintaining a pregnancy on a short time.
Indications for the installation of the pessary ring during pregnancy
According to the instruction, the pessary during pregnancy is established:
- with ischemic-cervical insufficiency (including the short cervix of the uterus);
- when there are several fruits in the womb of the mother, pressing on the cervix, thereby facilitating its unfoldment;
- in order to prevent ischemic-cervical insufficiency.
Gynecologic pessary during pregnancy helps reduce the burden on the cervix, displacing the area of pressure of the fetal egg. After installing this device, the cervix closes and the probability of a fetal loss decreases; while the mucous plug remains, and, hence, the risk of penetration to the fetus infection. The woman's pains decrease and, as a consequence, her psycho-emotional state improves, the woman ceases to worry about her child's life.
How do they put pessaries in pregnancy?
Installation of pessaries is not particularly difficult. It is carried out both permanently and outpatiently. The procedure is well tolerated by pregnant women. If a woman has an increased level of sensitivity of the uterus, then for 30-50 minutes before the procedure, it is recommended that she take a No-shpa pill. The procedure is carried out on an empty bladder and lasts only a few minutes: first the ring is treated with gel or ointment (glycerin or Clotrimazole) and then injected into the vagina.
After the pessary is installed every 2-3 weeks, bacteriological examination of pregnant smears is carried out, and every 3 to 4 weeks - ultrasonography for monitoring the condition of the cervix.
After staging an obstetric ring, a normal vaginal sex to a pregnant woman is contraindicated.
When wearing, it is possible to shift the pessary and can develop a mechanical colpitis, characterized by the appearance of whites. This problem is easily eliminated during gynecological examination.
Contraindications to the installation of pessaries in pregnancy
Do not install a pessary during pregnancy if a woman has spotting in the second and third trimesters. Contraindications are also the conditions when prolongation of pregnancy can be dangerous, or a woman has inflammation of the cervix and vagina.
When a pessary is removed during pregnancy?
The obstetric ring is removed during the gestation period of 36-38 weeks. In some cases, the pessary is removed ahead of schedule. This is done if necessary emergency delivery, the outflow of amniotic fluid, with the development of chorioamnionitis.