Pessary obstetrician: what is it? An obstetric discharge pessary is a mechanical device that is used to maintain the bladder, uterus and rectum. It is also prescribed to pregnant women for the prevention of preterm delivery, in which the ICI( ischemic-cervical insufficiency).


When is it used?

  1. Multiple pregnancy.
  2. Pregnant women who are at risk for developing ischemic-cervical insufficiency.
  3. Organic and functional istrmico-cervical insufficiency, this includes the prevention of joint failure when correcting ICI by surgical means.
What is an obstetric pessary?

Made pessary obstetrics made of very pure and biologically inert material. This device has a large base, it is directed toward the rectum, and a small base is adjacent to the lump articulation. The bases have a concave surface, so the rectum and the bladder are not squeezed. The central hole is made specifically for the cervix, it is located closer to the large base, eccentric and its center is on the anteroposterior axis. There are additional openings for the outflow of the vaginal secretion from the central hole along the periphery. In pessaries obstetrician there are no corners, they are made by semirings, lateral edges are also rounded. Between the holes there are small bridges, which provide rigidity and strength of the structure.

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In general, pessaries obstetric are available in three sizes.

Mechanism of action

  1. The load on the inconsistent neck decreases as a result of displacement of the pressure of the fetal egg.
  2. Intrauterine pressure is partially redistributed to the anterior wall of the uterus due to the fact that the obstetric pessarium is located ventrally-obliquely.
  3. There is a physiological sacralization of the cervix due to the fixation of the pessary obstetrician in the central hole, which is displaced "posteriorly".
  4. The closure of the cervix with the central hole of the pessary obstetrics.
  5. Due to a decrease in sexual activity, the probability of infection decreases, the preservation of the mucous plug.
  6. Improvement of the psychoemotional state of a woman.

In general, the total impact of obstetric pessaries reduces to sacralization of the cervix, closure of the cervix, better formation of partially open and shortened cervix, redistribution of the fetal egg.

Contraindications to the use of

Such a device can not be used:

  1. If there are diseases in which prolongation of pregnancy is contraindicated.
  2. As the most basic way to treat cervical insufficiency, when the prolapse of the bladder is expressed.
  3. With bleeding recurring discharge from the genital tract in the second and third trimesters.

If inflammatory diseases of the cervix, vulva, vagina are detected, then a sanation with subsequent bacteriological control is necessary.

Remember! In no case is the obstetric pessary not intended to correct the prolapse and omission of the genitals.

How to choose a pessary obstetrics?

As already mentioned, the obstetric pessary is available in three sizes. Choose a specific size depends on the individual anatomical features of your genitals.

Pessary of the first type will suit women who have the size of the upper third of the vagina 55-65 mm, the diameter of the cervix is ​​23-30 mm, with the birth should be no more than two.

The second type of Pessary is suitable for women who have a size of the upper third of the vagina 66-75 mm, the diameter of the cervix is ​​25-30 mm, while there should be no more than two births.

Pessary of the third type is intended for women, whose size of the upper third of the vagina is 76-85 mm, the diameter of the cervix is ​​30-37 mm, while giving birth should be two or more.

In any case, assign this device to you and select a type should only be a qualified doctor.

How is pessary obstetrics administered?

  1. First of all, the doctor should examine the woman, and with the bladder emptied, after which the obstetric pessary is positioned vertically, so that the base is located at the entrance to the vagina. The lower semicircle of the broad base is inserted into the vagina. After that, the upper half-ring of the wide base is inserted, with a little pressure on the back wall of the vagina.
  2. Next, you need to deploy the obstetric pessary in the vagina in the oblique plane, if we speak about the longitudinal axis of the woman's body. The wide base should be displaced in the posterior vaginal vault, while the small base should be located under the pubic articulation, and the cervix should be in the central hole of the mechanical device. Recesses that are in large and small bases protect the rectum and urethra from excessive squeezing. Because of the successful shape of the pessary obstetrics and the peculiarities of the trophic tissue of the vagina during the bearing of the child with the correct size of the device, the risk of trophic disturbances is reduced to a minimum.

The pessary is installed very simply, it does not need anesthesia and the patients tolerate this procedure very easily. In the form of a sliding agent, doctors usually use glycerol. And in outpatient and inpatient settings, you can enter a pessary obstetrician. If there is a problem of increased excitability of the uterus, then half an hour before the introduction you need to take antispasmodics in the usual dose.

How is pessary obstetrics removed?

As a rule, obstetrician pessaries are removed when a woman reaches 37-38 weeks of pregnancy in both outpatient and inpatient settings. The extraction technique is like an introduction. Pull out the pessary easily, painlessly and simply. If there is a problem of increased excitability of the uterus, you must again take antispasmodics in the usual dose. After the pessary is removed, it is necessary to sanitize the genital tract, taking into account the nature of the microflora of the woman's vagina.

Clinical situations that require sufficient removal of the pessary obstetrics:

  1. The phenomenon of chorioamnionitis.
  2. In case of emergency delivery.
  3. Development of labor activity( during the birth of pessaries it is extracted without special difficulties).
  4. Premature discharge of amniotic fluid.

Remove a pessary obstetrician every woman can independently, but doing this is not recommended.

Observation and examination of pregnant women who use the obstetric pessarium

Every two to three weeks it is necessary to undergo a bacterioscopic examination. It is necessary to constantly monitor the cervical state, at the same time it is necessary to focus on the result of ultrasonography in dynamics( every month).

ICS can be treated with pessaries obstetrician in combination with any other medical therapy that is aimed at maintaining and maintaining pregnancy, and when a woman has a severe degree of NI, then the surgical method of correction is also applied.

As a rule, when using pessary obstetric discharging complaints do not arise.

Some pregnant women who have been prescribed obstetrician pessaries feel painful pains. Very often this condition occurs due to the displacement of the pessary obstetrics, and this leads to the development of mechanical colpitis. The reason for this to recognize and eliminate is fairly easy when viewed.

If nonspecific bacterial colpitis develops, then there may be a sanation due to the pessary obstetrics. Treatment can last up to two weeks. If there is no sanation effect on the background of the mechanical device, then you need to temporarily remove it.

Pessary obstetrics is sterile and comes in an individual package. The expiration date( sterility) you can see on the package.

Remember that an obstetric pessary can only be used once, it can not be reused.