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Prophylactic use of the Arabin cervical pessary in fetuses with severe congenital diaphragmatic hernia treated by fetoscopic endoluminal tracheal occlusion (FETO): preliminary experience
Author(s) -
Dobrescu Oana,
Cannie Mieke M.,
Cordier AnneGael,
Rodó Carlota,
Fabietti Isabella,
Benachi Alexandra,
Carreras Elena,
Persico Nicola,
Hurtado Ivan,
Gucciardo Léonardo,
Jani Jacques C.
Publication year - 2016
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4716
Subject(s) - medicine , pessary , diaphragmatic hernia , gestational age , congenital diaphragmatic hernia , cervical insufficiency , surgery , cervix , gestation , obstetrics , diaphragmatic breathing , fetus , hernia , pregnancy , alternative medicine , pathology , cancer , biology , genetics
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.