【摘要】 目的探讨宫颈环扎术治疗双胎妊娠宫颈机能不全患者的有效性和安全性。方法回顾性分析2012年2月至2019年8月就诊于华中科技大学同济医学院附属同济医院并被诊断为宫颈机能不全的双胎妊娠患者51例,根据是否施行宫颈环扎术将患者分为宫颈环扎组和保守治疗组,分析患者的基本特征并比较两组的妊娠结局及新生儿情况。结果与保守治疗组比较,宫颈环扎组有晚期流产史者比例较高,延长孕天数较多,差异均有统计学意义(均P<0.05)。两组未足月胎膜早破率、晚期流产率、<32周早产率、<34周早产率、<35周早产率、<37周早产率、分娩孕周、剖宫产率、Apgar评分1 min<7分发生率、Apgar评分5 min<7分发生率、低出生体重儿率、极低出生体重儿率、新生儿重症监护病房转入率比较,差异均无统计学意义(均P>0.05)。比较两组患者在宫颈长度≤25 mm,以及宫颈长度≤15 mm、15 mm<宫颈长度≤25 mm时的妊娠结局,结果显示:两组未足月胎膜早破发生率、晚期流产率、<37周早产率、<35周早产率、<34周早产率、<32周早产率、分娩孕周、延长孕天数比较,差异均无统计学意义(均P>0.05)。结论双胎宫颈机能不全患者进行宫颈环扎术的临床治疗效果和保守治疗无显著差别,对双胎妊娠宫颈机能不全患者不建议施行宫颈环扎术。更多还原

【Abstract】 Objective To investigate the effectiveness and safety of cervical cerclage in the treatment of patients with cervical insufficiency in twin pregnancies.Methods In a retrospective review, clinical data of 51 cases of women who were diagnosed with cervical insufficiency were assessed between February 2012 and August 2019 at Tongji Hospital, Wuhan, China.Patients were divided into cervical cerclage group and conservative treatment group according to whether cervical cerclage was performed or not.The basic characteristics of the patients were analyzed and the pregnancy outcomes and neonatal outcomes of the two groups were compared.Results There were significant differences in the history of late miscarriage, the prolonged days of pregnancy between the conservative treatment group and the cervical cerclage group(P<0.05).There were no significant differences in the rates of premature rupture of membranes, late abortion rate, preterm delivery rate at <32 weeks, preterm delivery rate at <34 weeks, preterm delivery rate at <35 weeks, preterm delivery rate at <37 weeks, delivery gestational age, cesarean section rate, Apgar score <7 at 1 min, Apgar score <7 at 5 min, low birth weight, very low birth weight, and neonatal intensive care unit transfer(all P>0.05).When the cervical length was ≤15 mm, 15-25 mm, and ≤25 mm, respectively, the pregnancy outcomes of the two groups were compared, and the results showed that there were no statistically significant differences in the incidence of premature rupture of membranes, late miscarriage rate, preterm delivery rate at <37 weeks, preterm delivery rate at <35 weeks, preterm delivery rate at <34 weeks, preterm delivery rate at <32 weeks, delivery gestational age, and prolonged days of pregnancy between the two groups(P>0.05).Conclusion By using cervical cerclage, the clinical outcome of patients with cervical insufficiency in twin pregnancies is not significantly different from that of conservative treatment, and cervical cerclage is not recommended for patients with cervical insufficiency in twin pregnancies.更多还原