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Re: Pessary and preterm laborFrom: Braun, R. Daniel (rbraun@iupui.edu)Fri Mar 19 05:11:39 1999
Many years ago, Ed Yosowitz in Houston developed a "Double Doughnut" pessary for use in patients with incompetent cervix. I seem to remember that there were 2 or 3 articles on it. Dan R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN -----Original Message----- From: jane@seasonedsystems.com [SMTP:jane@seasonedsystems.com] Sent: Friday, March 19, 1999 6:53 AM To: Multiple recipients of list Subject: Pessary and preterm labor I have a patient with preterm labor at 32 weeks. Her sister is also pregnant and has a history of delivery at 35 weeks with an earlier pregnancy. The sister is being cared for elsewhere by a "specialist" (I assume a perinatologist) who has placed a pessary in the sister to prevent preterm delivery in this pregnancy. This doctor told the family that his wife had used a pessary for preterm labor and she had gotten to 36 weeks--the doctor felt she would have delivered sooner without the pessary. I am not familiar with the use of a pessary for preterm labor. A literature search shows one recent case report in J Reprod Med, plus a few other reports. It sounds as though a pessary might theoretically be helpful when the cervix is prolapsing, to elevate it and relieve some pressure. Has anyone had experience with using pessaries in preterm labor? I am not contemplating using one in my current patient, but would like to know more, if only to stay up to speed with my patient's family who now consider pessaries part of preterm labor care. Thanks for your input. Jane -- Jane Helwig, MD Private practice Nassawadox, VA
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