Last update:
24-May-2026

OBJECTIVE To investigate a possible relationship between preterm birth (PTB) prevention via pessary insertion and fetal heart rate variability (HRV), term of birth, neonatal biometry, and Apgar score in women with a short cervix (ShC).

METHOD A total of 64 patients with threatened preterm delivery and ShC between 22 and 30 weeks of gestation were enrolled in the study. Thirty patients treated with acute tocolysis, chronic use of nifedipine, progesterone, and cervical pessary insertion were included in group I. Thirty-four pregnant women treated with acute, and chronic tocolytics and progesterone were included in group II. All patients included in the study had no personal history of spontaneous miscarriages or PTB. HRV parameters were obtained from an RR-interval time series recorded from the maternal abdominal wall fetal non-invasive electrocardiography (FNI-ECG). The study protocol also included several parameters: term at birth, neonatal body weight, body length, head circumference, and Apgar score.

RESULTS The data on fetal HRV, term at birth, neonatal anthropometry, and Apgar score revealed certain regularities. The mean gestational term at birth was significantly higher in group I. This fact demonstrated that pessary was a useful part of the therapeutic strategy in patients with threatened PTB. The prolongation of pregnancy until the stage of fetal complete development reflected the statistically significant difference of neonatal biometry variables and a tendency to a statistically significant difference in Apgar score between the representatives of groups I and II. The logistic regression model with term of birth showed the relationship with Apgar score and the pessary insertion.

CONCLUSIONS Pessary was an efficient supplement to tocolytics and progesterone in women with threatened PTB. The insertion of pessary contributed to pregnancy prolongation.

Key words: Fetal growth and maturation, Pessary, Preterm birth, Preventive interventions.