Obstetric pessary during pregnancy and its functions

word "pessary" derives from both underlying medical language.From the Greek (pessos - oval stone for sports games) and Latin (pessarium - «measures the force of gravity").Pessary during pregnancy simultaneously performs two functions:

  • hold internal organs (uterus) in the right (correct position);
  • Preventing loss of internal organs, due to the reduction of the force of gravity.

In medicine, a pessary is an oval or circular plate of silicone or plastic.Pessary during pregnancy inserted into the vagina to prevent preterm labor with cervical incompetence.

Outside of pregnancy the use of pessary use incontinence, conservative treatment for hernia bladder.Less frequently, for contraception.

obstetric pessary

method of treating obstetric pessary used during pregnancy when cervical incompetence.This term denotes the failure of uterine throat.cervical canal expanded shell ovum available slack in the birth canal.There is a risk of preterm labor beginning.Indications for use of a pessary in pregnancy are

the following states:

  • Incomplete closure of the uterine mouth in the area of ​​the isthmus;
  • Prevention insolvency seams after surgical correction of isthmic-cervical insolvency;
  • presence of multiple pregnancy.

obstetric pessary made of a material that does not cause allergic reactions, and then sterilized using gamma radiation.Selection of material and sterilization hinder the development of the reaction of foreign body rejection.

pessary during pregnancy is a truncated pyramid with concave bases.The wide end is located below to the rectum, small base adjacent to the pubic articulation.Hole for cervical done in the form of a channel on the anteroposterior axis of the pelvis.Additional openings are provided for the outflow of the vaginal secretion.The network between the holes is made from a rigid material webs, which prevents deformation of the pessary, during pregnancy it is in the vagina to weed out a long time, and the displacement of cervical equalizer is inadmissible.

mechanism of action of the pessary during pregnancy

corrective function pessary provide the following processes:

  • Reducing the load on the cervical receptors bulging in the channel lumen of the membranes;
  • Redistribution of intrauterine pressure to the front wall of the body plodovmestilischa;
  • Fixing the cervical canal in a position to the rear vaginal vault;
  • Achieving complete closure of the cervix due to the opening of the central hole pessary during pregnancy, which effortlessly squeezes her walls;
  • formation of mucus plug, which prevents the spread of intrauterine infection;
  • Correction emotional state of a pregnant.

pessaries during pregnancy are available in three sizes, the size of which depends on the size of the cervix and vagina in diameter capacity.

Contraindications for use in pregnancy pessary

In some states setting pessary is prohibited, as it can cause additional, extremely undesirable complications.Not allowed to use the pessary during pregnancy in cases where:

  • are defined inflammatory changes in the vaginal flora;
  • appear spotting;
  • In extreme cervical incompetence - as the main type of correction.

If inflammatory processes occur during a pregnancy pessaries, made reorganization of the birth canal with the mandatory bacteriological control.

Installation pessary

The procedure is simple and is carried out at the reception in the antenatal clinic, that is, on an outpatient basis.In a hospital setting pessary produced only in those cases where cervical incompetence is diagnosed during treatment in the department.

Before pessary administered during pregnancy, the patient empties the bladder to the front vaginal vault does not prevent manipulation.Pessary is put in the position of the patient lying on the couch.Produced installation pessary broad base to enter the vagina.First introduced the lower half of the ring, and then, the second semi-circle - in the posterior fornix.

pessary When fully inserted into the vagina, it is necessary to properly install it.To this end, in unfolded ring kosopoperechnuyu pelvic plane so that the wide base lonnomu turned facing the articulation, and the cervix was within the central hole.

notches located on the sides of the pessary not allow pressure on the urethra and rectum foreign body.

As a rule, the installation does not require anesthesia pessary.Glycerine is used in the vagina to facilitate the movement of the oil ring.In cases where marked lability uterine muscle, to avoid start contractile activity before pessary administered during pregnancy, the patient is prescribed a prophylactic dose antispasmodics.Take them for a half hour before the start of manipulation.

pessary obstetric unload

unload is called a pessary during pregnancy, not only because of its setting reduces the load on the uterus, but in contrast to the pessary, which is installed outside of pregnancy, they have a completely different task: uterine retention in the pelvic cavity or contraception.

Important!Pessary obstetric unload ineffective in descent and prolapse of the uterus!For women suffering from disorders ligaments, requires a completely different design royal ring.

pessary removal during pregnancy

Routinely pessary is removed in 37-38 weeks of pregnancy, according to emergency indications - immediately.

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