PRETERM BIRTH PREVENTION IN MULTIFETAL PREGNANCIES: A RETROSPECTIVE STUDY ON CERVICAL PESSARY EFFICACY.

Aim of the study: the assessment of the efficacy of pessary in Preterm Birth (PB) prevention in patients with multifetal pregnancies.

Material and methods: The retrospective cohort study was conducted in the Perinatal Department of Gudushauri National Medical Center from 2020 to 2024 and included 226 women only with multifetal pregnancies and threatened PB. The patients were divided into three groups: group I - 68 patients who conceived naturally and a pessary was used to prevent the preterm delivery; group II - 84 pregnant women after assistive reproductive technologies (ART) and the treatment of premature birth was also provided using a pessary; and group III - 74 women with threatened preterm delivery in whom a pessary was not used for the prevention. In all cases the pessaries were inserted between 14-24 weeks of gestation. The difference was statistically significant if P<0.05.

Results: In group I, the frequency of late preterm delivery - n=35 (51.47%) was statistically significantly higher compared to moderate - n=24 (35.29%), very preterm - n=7 (10.29%) and extremely preterm - n=2 (2.94%) delivery rates (P<0.001). The same tendency was revealed as in patients after IVF and pessary insertion, so in patients without pessary (P<0.001). However, a statistically significant difference was not found when comparing rates between groups (P>0.05).

Conclusion: The use of pessary in multifetal pregnancies must be regarded as supportive therapy as it may prolong the pregnancy, however, it does not prevent the preterm delivery.