Today we bring very encouraging news to reduce the number of premature births and neonatal mortality. It has been known that insertion of a cervical ring during the first trimester of pregnancy in women who have a high risk of preterm birth significantly reduces the likelihood of premature delivery.
It has been demonstrated thanks to a trial conducted at the Vall d'Hebron Hospital (Barcelona) that proceeded to place a silicone ring in the uterus of women with a short cervix. Specifically, this ring reduce premature births by 75% in risky pregnancies
The study, published by the British magazine "The Lancet", has had an international impact, since it is a great achievement. The effectiveness of this silicone ring, also known as a pessary, has been proven on a sample of 15,000 women who had a short cervix in common (length of 25 millimeters), which is a risk factor for premature births.
The low cost and the minimum intervention to place this ring are some of its advantages. The pessary used costs 38 euros, is introduced through the vagina by bending it, without surgery, and does not cause discomfort or side effects. Once deployed in the matrix, acts like a plug, which prevents the fetus from facing the vagina and forces it to regain normal position.
Once week 37 of gestation is reached, the ring is removed through the vagina so that the woman can give birth normally.
Preterm birth (before 34 weeks gestation) is the leading cause of serious illness and mortality of the newborn. The short cervix (with a cervical length of 25 millimeters) causes the musculature of the uterus not to have sufficient strength to retain the weight of pregnancy, and therefore the delivery occurs early.
To reduce this prematurity rate, it would be sufficient for public health extend the ultrasound of the 20 weeks of gestation to the vaginal area which, by system, is practiced for all pregnant women.
This would detect cases of short cervix (usually women do not know because this malformation does not cause any discomfort and is only detected by ultrasound) and the uterine ring could be implanted to delay labor. The length of the cervix is an indicator of the risk of premature delivery and that is why some clinics already include this ultrasound among their routine practices.
In the study, which has been financed by the Carlos III Health Institute, other patients from five other Spanish centers have collaborated: the Fuenlabrada Hospital (Madrid), the Maternal and Child of Las Palmas de Gran Canaria, the Son Llàtzer of Palma de Mallorca , that of Sant Joan de Reus (Tarragona) and the Dexeus Institute of Barcelona.
The pessaries are made disabled by the German NGO Clara-Angela-Foundation of Dr. Birgit Arabin, who, in 2003, made the first studies on the benefits of these rings, although it has not been so far that they have been tested in a randomized study on a large scale
As we see, it is a very simple and cheap system, the uterine ring that reduces premature births by 75% It is a hope for many risky pregnancies and hopefully it will save many lives. Most of the women who used it point out that they are very happy with the system and its results.
