Prophylactic use of the Arabin cervical pessary in fetuses with severe congenital diaphragmatic hernia treated by fetoscopic endoluminal tracheal occlusion (FETO): preliminary experience. (1st December 2015)

• Record Type: Journal Article
• Authors: Dobrescu, Oana; Cannie, Mieke M.; Cordier, Anne‐Gael; Rodó, Carlota; Fabietti, Isabella; Benachi, Alexandra; Carreras, Elena; Persico, Nicola; Hurtado, Ivan; Gucciardo, Léonardo; Jani, Jacques C.
• Is Part Of: Prenatal diagnosis. Volume 36:Number 1(2016)
• Page Start: 81
• Page End: 87
• Publication Date: 2015-12-01
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4716
• Languages: English
• ISSNs: 0197-3851

Abstract

Abstract: Objective: The aim of this study was to describe whether the prophylactic use of a cervical pessary decreases the rate of premature birth in congenital diaphragmatic hernia (CDH) fetuses treated with fetoscopic tracheal occlusion (FETO). Methods: The study concerns a consecutive series of cases with CDH and FETO and a group of CDH without FETO. In a subgroup of the FETO group, a prophylactic cervical pessary was inserted the day following the procedure. Gestational age (GA) at birth was the primary outcome. Results: Fifty‐nine fetuses with FETO and 47 expectantly managed were included. The last 15 FETO had a cervical pessary inserted. The median GA at delivery in the FETO group with pessary was 35.1 weeks and was not different from that in the FETO group without a pessary (34.3 weeks; p = 0.28) but was below that in the expectantly managed group (38.3 weeks; p < 0.001). Conclusion: Early results suggest that prophylactic use of an Arabin cervical pessary does not prolong gestation of CDH fetuses treated with FETO. © 2015 John Wiley & Sons, Ltd. Abstract : WHAT'S ALREADY KNOWN ABOUT THIS TOPIC? There is some evidence that fetoscopic endoluminal tracheal occlusion (FETO) improves survival in fetuses with severe congenital diaphragmatic hernia. However, preterm delivery after FETO and therefore prematurity‐related mortality remains a major concern. WHAT DOES THIS STUDY ADD? Prophylactic use of a pessary in patients undergoing FETO does not prolong gestation.