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Prophylactic use of the Arabin cervical pessary in fetuses with severe congenital diaphragmatic hernia treated by fetoscopic endoluminal tracheal occlusion (FETO): Preliminary experience

par Dobrescu, Oana Gabriela ;Cannie, Mieke ;Cordier, Anne Gaël;Rodó, Carlota;Fabietti, Isabella;Benachi, Alexandra;Carreras, Elena;Persico, Nicola;Hurtado, Ivan;Gucciardo, Leonardo ;Jani, Jacques
Référence Prenatal diagnosis, 36, 1, page (81-87)
Publication Publié, 2016-01

Article révisé par les pairs

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Résumé :

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 35.1weeks and was not different from that in the FETO group without a pessary (34.3weeks; p=0.28) but was below that in the expectantly managed group (38.3weeks; 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.