Drs S J VINE and A PRYS-DAVIES and Mr J F PEARSON (University Hospital of Wales, Cardiff CF4 4XN) write: A 16 year old woman was admitted for termination of her first pregnancy at 16 weeks' gestation. A gemeprost (16,16-dimethyl-trans-A2 prostaglandin El methyl ester) 1 mg pessary was inserted into the posterior fomix every three hours until a total dose of 5 mg had been given. The cervix remai...

BACKGROUND Fetoscopic LASER coagulation of the placental anastomoses has changed the prognosis of twin-twin transfusion syndrome. However, the prematurity rate in this cohort remains very high. To date, strategies proposed to decrease the prematurity rate have shown inconclusive, if not unfavourable results. METHODS This is a randomised controlled trial to investigate whether a prophylactic c...

Prevention of spontaneous preterm birth is an important public health priority. Pessary may be a potential therapy in cases of cervical insufficiency, in singleton and multiple gestations. Availability of transvaginal sonography for accurate assessment of cervical length is allowing for the tailoring of therapy to a more specific subset of patients who may benefit from this treatment. Pessary t...

To cite: Christopoulos G, Munn C. BMJ Case Reports Published online: 3 December 2012 doi:10.1136/bcr-2012007540 DESCRIPTION A 52-year-old patient presented with suprapubic pain, mild vaginal bleeding and continuous urinary incontinence. The patient was nulliparous with a history of cerebral palsy and mild learning difficulties. A bimanual examination revealed a hard and calcified vaginal mass, ...

Preterm birth remains a considerable public health concern and priority. Little headway has been made in the prevention of preterm birth despite considerable research in this area. New ideas and treatments are desperately needed. The pessary has emerged as a possible treatment for the prevention of preterm birth in both singleton and twin gestations. It appears to be low cost with minimal side ...