EP02.04: 3D transvaginal ultrasound to evaluate the Arabin pessary position

Abstract

To evaluate 2D and 3D ultrasound features of the Arabin pessary in order to confirm its correct position. High-risk patients for preterm delivery with an indication for Arabin pessary placement were recruited over a period of 6 months. Immediately after the pessary placement 2D and 3D transvaginal ultrasound (TVU) images and volumes were acquired by a senior sonographer. After the scan, a further digital vaginal examination was performed to check the pessary position. Images were reviewed and volumes processed in order to define the relationship between pessary and maternal anatomic structures (cervix and vagina). Images were assessed by 3D multiplanar mode and 3D “thick slice” sagittal and coronal rendering. The position of the pessary was considered correct when its orientation was perpendicular to the cervical axis and the smaller ring of the device was seen to encircle completely the cervix. Overall, 14 patients were included in the study. In all, the position of the pessary had been judged in place at digital examination. At TVU the correct position of the pessary was sonographically ascertained in 13 (figure 1 A, C, D), whereas in a single patient the cervix appeared to lay on the pessary but not to be fully encircled by the device (figure 1 B, E). 2D and 3D TVU allows a reliable evaluation of the position of the Arabin pessary immediately after its placement. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.