Many expectant mothers will find out what an obstetric pessary is in their doctor’s office. When a specialist sees a woman’s early opening of the cervix, which threatens with miscarriage and premature birth, he appoints the installation of a retaining ring.
An obstetric unloading pessary is a uterine ring that is inserted into the vagina and secured to the cervix.
It can be of several types:
- Type 1 – suitable for the first pregnancy in a woman with a size of the upper third of the vagina in 55-65 mm and a neck diameter from 25 to 30 mm.
- Type 2 – for the first and second pregnancy, the vagina is 66-75 mm in size and the neck diameter is 25-30 mm.
- Type 3 – for the third and subsequent pregnancies, a vagina with a size of 76 mm and a neck diameter of at least 30 mm.
Doctors call the pessary the “ring”, although this device does not always have a rounded shape. Now you can find a cubic, cup, mushroom and oval appearance. Which one is most suitable for the expectant mother, the specialist decides after the examination.
Need to install
The main reason why an obstetric unloading pessary is installed is the threat of premature birth or miscarriage.
Many women before pregnancy may not realize that they have a weak cervix, a tendency to isthmic-cervical insufficiency. Only at a routine examination, when the fetus begins to actively gain weight, doctors see the walls of the neck are too weak, which, under the influence of uterine pressure, begin to relax. This leads to early disclosure.
In many cases, doctors recommend buying and installing a pessary for the purpose of caution, if the patient previously had a miscarriage. But, despite the complete safety of the device, nevertheless, there must be indications for its installation.
How and when is the pessary installed?
The optimal period for installation is 20 or more weeks. In rare cases, an exception is made, but 1 type of ring is used, even if the pregnancy is not the first. Most often, it is administered at a period of 28-33 weeks, when there is a real threat of premature birth. After 35 weeks, there is no longer any need to maintain the cervix – the fetus is fully formed and childbirth ends safely.
The pessary is installed only by the obstetrician or gynecologist according to the instructions! Doing it yourself is dangerous! The procedure is almost painless, if a woman has an increased sensitivity, then the doctor can sprinkle the vagina with an anesthetic or use a special cream. The ring is lubricated with glycerin and inserted into the vagina to the neck, where the ring is fixed. It takes no more than 10 minutes, during which you need to relax.
The unloading pessary is removed for a period of 38 weeks. This leads to a relaxation of the cervix, as a result of which labor can begin. If amniotic fluid is poured out earlier than this period, then the holding device is removed urgently.
Where to buy and cost
The most commonly used pessary is the Ukrainian company Juno. The products are completely safe, made from environmentally friendly anti-allergenic materials. Juno products do not cause discomfort when inserted and worn. Its cost ranges from 300 to 800 rubles.
You can purchase more expensive analogues from foreign manufacturers, which have a price of 1000 rubles. They also have three types: 1,2 and 3, are made from safe soft material. Doctors do not observe the fundamental difference, but women feel less pain with foreign models.
You can buy products of the company Juno at any pharmacy. If there is no such product available, then place an order. Within 1-2 weeks, the pessary will be delivered to the pharmacy. You can buy a uterine ring at a low price on the Internet, directly from the manufacturer. Only delivery often is more than 3 weeks.
Contraindications and side effects
Unfortunately, pessaries of type 1, 2, or 3 are not suitable for everyone. If the pregnant woman had spotting after 12 weeks, then installing the ring is contraindicated. The uterine device is not suitable for women with genital tract diseases, for starters they need to be cured so as not to cause complications.
With regard to side effects, most often the ring causes polpit (inflammation) when displaced. It is not difficult to determine this – a woman begins to feel discomfort, soreness. Genital irritation is less common, and infectious diseases are even less common. This happens if the doctor incorrectly selected the type of pessary (instead of 1, put 2, for example). Moreover, the price of the device does not matter. It happens that an expensive foreign pessary is less tolerated by the body than Juno products.
It is recommended for patients who have an unloading pessary installed to abandon sexual activity. But this issue is discussed individually in each case.
If the doctor recommends that you install a pessary to maintain pregnancy, then do not refuse. No need to count on a miracle and fear unpleasant sensations. A child is much more expensive, and a five-minute procedure can be easily transferred if you relax and trust a specialist.