Gervaise A, Senat M V, Audibert F, Frydman R, Fernandez H
Hôpital Antoine Béclère, 157, rue de la Porte de Trivaux, 92141 Clamart Cedex.
J Gynecol Obstet Biol Reprod (Paris). 2000 Oct;29(6):579-87.
We performed a retrospective study to evaluate the results of a new approach to cervical cerclage using a prosthetic band.
Twenty-four patients were recruited over an 8-year period between 1991 and 1999. All had a history of at least two late abortions and/or preterm delivery and a failed attempt with McDonald or Hervet cerclage. We used a cervical cerclage technique with prosthetic band inspired from the Shirodkar technique but which has been simplified and quite easy to reproduce. The technique consists in placing a prosthetic band around the internal os under the vaginal mucosa at the vesicovaginal reflection level. Outcome of pregnancy before and after inserting the prosthetic band was compared.
Outcome of 28 pregnancies after cerclage were assessed (4 patients had two successive pregnancies with the same cerclage left in place). 82% of the children were liveborn after cerclage versus 21.7% before cerclage. 53.3% of the patients delivered at term after cerclage versus 2.8% before cerclage. We had 7.1% late miscarriages after cerclasge versus 65.2% before. There were no surgical complications. 22 of the 23 liveborn children were delivered by cesarean section. Conclusion. These results show that the cervical prosthesis is a solution of these patients with an obstetric history of cervical incompetence with failure of classical techniques.
我们进行了一项回顾性研究，以评估使用人工带进行宫颈环扎术的新方法的效果。
在1991年至1999年的8年期间招募了24名患者。所有患者都有至少两次晚期流产和/或早产史，并且麦克唐纳或埃尔韦宫颈环扎术尝试失败。我们采用了一种受希罗德卡尔技术启发的人工带宫颈环扎术，但该技术已被简化且易于重复操作。该技术包括在膀胱阴道反折水平的阴道黏膜下将人工带放置在内口周围。比较了插入人工带前后的妊娠结局。
评估了28次环扎术后的妊娠结局（4名患者有两次连续妊娠且同一环扎带未取出）。环扎术后82%的婴儿存活，而环扎术前为21.7%。环扎术后53.3%的患者足月分娩，而环扎术前为2.8%。环扎术后晚期流产率为7.1%，而术前为65.2%。无手术并发症。23名存活婴儿中有22名通过剖宫产分娩。结论。这些结果表明，宫颈假体是这些有宫颈机能不全产科病史且传统技术失败的患者的一种解决方案。
