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The Role of Cerclage and Pessaries
Published in Howard J.A. Carp, Recurrent Pregnancy Loss, 2020
Israel Hendler, Howard J.A. Carp
Another technique that has come into use for encircling the cervix is the cervical pessary. The Arabin pessary is the most commonly used such device. However, the idea of using a pessary is not new. In 1959, Cross described the use of a ring pessary in patients with cervical incompetence, lacerations, or uterine malformations [31]. Since then, other devices have been used, including the Hodge pessary and donut pessary (Figure 16.1 shows sonograms of the Hodge pessary in situ). The pessary has been described to act by pressing the internal os closed from behind, and by changing the inclination of the cervical canal. This change of position may prevent direct pressure on the membranes at the internal os and on the cervix itself. The weight of the uterus may therefore be directed toward the lower anterior uterine segment rather than the cervix. The pessary has been reported to protect the cervical mucus plug by compressing the attachment of the remaining cervical tissue. The cervical mucus plug may protect the intrauterine cavity from ascending infection and subsequent miscarriage or preterm labor [32,33]. Cervical elongation after pessary insertion has also been shown by TVU [34].
Combined oral contraceptive methods
Published in Sarah Bekaert, Alison White, Integrated Contraceptive and Sexual Healthcare, 2018
Sarah Bekaert, Alison White, Kathy French, Kevin Miles
The main actions of the COC are: prevents ovulationcreates a cervical mucus plugimpedes implantation.
Diaphragmatic endometriosis minimally invasive treatment: a feasible and effective approach
Published in Journal of Obstetrics and Gynaecology, 2021
Andres Vigueras Smith, Ramiro Cabrera, William Kondo, Helder Ferreira
Many theories arise to explain this syndrome including the transposition of endometrial cells from peritoneal (menstrual reflux) to the pleural cavity through blood vessels, lymphatic channels or diaphragmatic fenestrations (Nezhat et al. 2012), prostaglandin-based lung ischaemia (Rossi 1974), and the loss of cervical mucus plug during menses (Cowl et al. 1999).