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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2019; 79(11): 1171-1175
DOI: 10.1055/a-1007-8613
GebFra Science
Statement
Georg Thieme Verlag KG Stuttgart · New York

Position Paper of the Task Force for Obstetrics and Prenatal Medicine (AGG – Section Preterm Birth) on the Placement, Removal and Surveillance of the Arabin Cervical Pessary in Patients at Risk for Spontaneous Preterm Birth

Positionspapier der Arbeitsgemeinschaft Geburtshilfe und Pränatalmedizin (AGG – Sektion Frühgeburt) zur Platzierung, Entfernung und Überwachung von Arabin-Zervixpessaren bei Patientinnen mit erhöhtem Frühgeburtsrisiko
Ioannis Kyvernitakis
1   Section of Prenatal Diagnostics and Therapy, Dept. of Obstetrics and Prenatal Medicine, Asklepios Center of Excellence Hamburg, Campus Barmbek, Heidberg-Nord and Wandbek, Hamburg, Germany
,
Holger Maul
2   Dept. of Obstetrics and Prenatal Medicine, Asklepios Center of Excellence Hamburg, Campus Barmbek, Heidberg-Nord and Wandbek, Hamburg, Germany
,
Werner Rath
3   Dept. of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
,
Katrina Kraft
4   Dept. of Obstetrics and Gynecology, Harlaching Hospital Munich, Munich, Germany
,
Ruben Kuon
5   Dept. of Gynecological Endocrinology and Fertility Disorders, University Hospital of Heidelberg, Heidelberg, Germany
,
Amr Hamza
6   Dept. of Obstetrics and Gynecology, University Hospital Saarland, Homburg, Germany
,
Edith Reuschel
7   Dept. of Obstetrics and Gynecology, University of Regensburg, Hospital of the Barmherzige Brueder, Clinic St Hedwig, Regensburg, Germany
,
Barbara Filsinger
8   Dept. of Obstetrics and Gynecology, Diakonissen Hospital Speyer, Speyer, Germany
,
Harald Abele
9   Center for Mother and Child, University-Hospital Tübingen, Tübingen, Germany
,
Yves Garnier
10   Dept. of Obstetrics and Gynecology, Osnabrück Hospital, Osnabrück, Germany
,
Franz Bahlmann
11   Dept. of Obstetrics and Gynecology, Buergerhospital and Clementine Childrenʼs Hospital Frankfurt a. M., Frankfurt a. M., Germany
,
Ekkehard Schleußner
12   Dept. Of Obstetrics and Prenatal Medicine, University of Jena, Jena, Germany
,
Richard Berger
13   Dept. of Obstetrics and Gynecology, Marienhospital Neuwied, Neuwied, Germany
› Author Affiliations
Further Information

Publication History

received 31 July 2019
revised 30 August 2019

accepted 02 September 2019

Publication Date:
11 November 2019 (online)

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Abstract

This position paper describes clinically important, practical aspects of cervical pessary treatment. Transvaginal ultrasound is standard for the assessment of cervical length and selection of patients who may benefit from pessary treatment. Similar to other treatment modalities, the clinical use and placement of pessaries requires regular training. This training is essential for proper pessary placement in patients in emergency situations to prevent preterm delivery and optimize neonatal outcomes. Consequently, pessaries should only be applied by healthcare professionals who are not only familiar with the clinical implications of preterm birth as a syndrome but are also trained in the practical application of the devices. The following statements on the clinical use of pessary application and its removal serve as an addendum to the recently published German S2-consensus guideline on the prevention and treatment of preterm birth.

Zusammenfassung

Dieses Positionspapier beschreibt klinisch wichtige praktische Aspekte der Zervixpessartherapie. Zur Beurteilung der Zervixlänge und um Patientinnen auszuwählen, die von einer Pessartherapie profitieren könnten, wird standardmäßig transvaginaler Ultraschall eingesetzt. Wie bei anderen Behandlungsmodalitäten auch, ist es wichtig, regelmäßig Schulungen zum klinischen Einsatz und zur Pessarplatzierung durchzuführen. Diese Schulungen sind unerlässlich, um eine korrekte Platzierung von Pessaren im Notfall zu gewährleisten, Frühgeburten zu verhindern und die neonatale Ausgangssituation zu optimieren. Pessare sollten nur von medizinischen Fachleuten eingesetzt werden, die nicht nur mit den klinischen Implikationen einer Frühgeburt als Syndrom vertraut sind, sondern auch in der praktischen Anwendung von Pessaren geschult sind. Die folgenden Aussagen zum klinischen Einsatz von Pessaren und deren Entfernung dienen als Ergänzung der vor Kurzem veröffentlichten deutschen S2-Richtlinie zur Prävention und Therapie der Frühgeburt.

Key words

Arabin pessary - preterm birth - prevention - recommendations - placement - removal - surveillance

Schlüsselwörter

Arabin-Pessar - Frühgeburt - Prävention - Empfehlungen - Platzierung - Entfernung - Überwachung
 

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