Prophylactic use of the Arabin cervical pessary in fetuses with severe congenital diaphragmatic hernia treated by fetoscopic endoluminal tracheal occlusion (FETO): preliminary experience

Prenat Diagn. 2016 Jan;36(1):81-7. doi: 10.1002/pd.4716. Epub 2015 Dec 1.

Abstract

Objective: The aim of this study was to describe whether the prophylactic use of a cervical pessary decreases the rate of premature birth in congenital diaphragmatic hernia (CDH) fetuses treated with fetoscopic tracheal occlusion (FETO).

Methods: The study concerns a consecutive series of cases with CDH and FETO and a group of CDH without FETO. In a subgroup of the FETO group, a prophylactic cervical pessary was inserted the day following the procedure. Gestational age (GA) at birth was the primary outcome.

Results: Fifty-nine fetuses with FETO and 47 expectantly managed were included. The last 15 FETO had a cervical pessary inserted. The median GA at delivery in the FETO group with pessary was 35.1 weeks and was not different from that in the FETO group without a pessary (34.3 weeks; p = 0.28) but was below that in the expectantly managed group (38.3 weeks; p < 0.001).

Conclusion: Early results suggest that prophylactic use of an Arabin cervical pessary does not prolong gestation of CDH fetuses treated with FETO. © 2015 John Wiley & Sons, Ltd.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Fetoscopy / adverse effects*
  • Fetoscopy / methods
  • Follow-Up Studies
  • Hernias, Diaphragmatic, Congenital / therapy*
  • Humans
  • Pessaries*
  • Pregnancy
  • Premature Birth / etiology
  • Premature Birth / prevention & control*
  • Prospective Studies
  • Retrospective Studies
  • Severity of Illness Index
  • Trachea
  • Treatment Outcome
  • Young Adult