Obstetric pessary: pros and cons, versions and controversies (A retrospective study)
Акушерлік пессарий: оң және теріс жақтары: нұсқалар мен қайшылықтар (ретроспективті зерттеу)
Акушерский пессарий, за и против: версии и контраверсии (ретроспективное исследование)
Jussubaliyeva Т.М. Sarmuldayeva S.К. Baimurzayeva L.G. Jaimbetova А.P. Khorun V.G.
30 December 2025Kaz Med Print LLP
Reproductive Medicine (Central Asia)
2025#2025Issue 4
Relevance: Preterm labor is the leading cause of perinatal mortality and disability. Various scholars propose different methods of management, ranging from surgical correction of cervical insufficiency during pregnancy, pessary insertion, and progestogen support to surgical correction of cervical insufficiency during preconception care. Despite its long history, the effectiveness of pessary insertion is still being debated. The study aimed to analyze the pregnancy outcomes and the condition of newborns in women with isthmic-cervical insufficiency, with and without a pessary. Materials and Methods: This retrospective statistical analysis included 297 pregnant women with an established diagnosis of cervical insufficiency, 158 without a pessary, and 139 with a pessary installed. Results: The groups with and without a pessary did not statistically differ from each other in age, anamnesis, parity, or extragenital diseases. Women with pessaries statistically significantly more often had surgical deliveries for the predominant indications of “elderly primiparous women. In the group without pessaries, the most common indications were “uterine scar” and “ineffectiveness of labor induction or stimulation”. In the group without pessaries, respiratory distress syndrome in newborns was more common, which may be associated with a higher incidence of premature births. Despite the large sample size, a statistical difference was found only in the indications for caesarean section: in the group with pessaries, operations were performed more often for relative indications, such as “older primiparous”. There were also more healthy women in the pessary group, but more cardiovascular diseases were found among patients with a pessary and any extragenital pathology. Conclusion: The use of a pessary should be considered individually, taking into account the clinical situation, reproductive history, and obstetric risks. In combination with regular ultrasound monitoring and hormonal support, a pessary can act as an effective method for preventing preterm labor in women with cervical insufficiency.
Caesarean section , fetal distress , isthmic-cervical insufficiency , preterm labor , progestogens
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Institute of Reproductive Medicine, Almaty, Kazakhstan
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Institute of Reproductive Medicine
Asfendiyarov Kazakh National Medical University
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