Department of Obstetrics and Gynecolgy, Toho Women's Clinic, Tokyo, Japan.
J Obstet Gynaecol Res. 2022 Jan;48(1):271-274. doi: 10.1111/jog.15079. Epub 2021 Oct 27.
A 37-year-old multiparous woman complained of uterine prolapse at 14 weeks of gestation. A silicone ring-shaped middle-size vaginal pessary (# 62 mm) was placed into the vagina to reduce prolapsed uterus. Because the cervical length became shortened at 25 weeks of gestation, we decided to start intramuscular administration of progesterone (250 mg) weekly. At 33 weeks of gestation, she complained of the vaginal pessary spontaneous falling out, so we inserted a vaginal pessary of the same size again. The uterocervical angle became acute, going from 100° to 60° after placing the vaginal pessary into the vagina. We took the vaginal pessary out at 37 weeks of gestation. The patient gave birth at 39 weeks by spontaneous vaginal delivery to a healthy baby. A vaginal pessary may help continue a pregnancy via the same mechanism as a cervical pessary, which sharpens the uterocervical angle.
一位 37 岁经产妇在妊娠 14 周时主诉子宫脱垂。我们将一个硅胶环形中号阴道子宫托（#62mm）放入阴道以减少脱垂的子宫。由于宫颈长度在 25 周妊娠时缩短，我们决定开始每周肌内注射黄体酮（250mg）。在 33 周妊娠时，她主诉阴道子宫托自发性脱出，因此我们再次插入了相同大小的阴道子宫托。阴道子宫托放入阴道后，子宫颈角变得锐角，从 100°变为 60°。我们在 37 周妊娠时取出了阴道子宫托。患者在 39 周妊娠时自然阴道分娩了一个健康的婴儿。阴道子宫托可能通过与宫颈子宫托相同的机制帮助继续妊娠，即锐化子宫颈角。
