Hassan S S, Romero R, Maymon E, Berry S M, Blackwell S C, Treadwell M C, Tomlinson M
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, Michigan 48201, USA.
Am J Obstet Gynecol. 2001 Jun;184(7):1325-9; discussion 1329-31. doi: 10.1067/mob.2001.115119.
Our purpose was to determine whether cerclage placement in women with a short cervix on transvaginal ultrasonography reduces the rate of preterm delivery.
A retrospective cohort study identified patients with an ultrasonographic short cervix (cervical length < or =15 mm) between 14 and 24 weeks' gestation. Cerclage placement was performed at the discretion of the attending physician. Clinical characteristics and outcome with and without cerclage were compared.
Seventy patients met inclusion criteria; 25 (36%) underwent cerclage placement. Patients managed with cerclage had a lower gestational age at diagnosis (19.6 weeks vs 21.3 weeks, P <.01) but had a similar median cervical length, presence of funneling, and a history of cervical surgery, in comparison with those managed without cerclage. The rate of spontaneous preterm delivery was not different between groups. Patients with cerclage had a higher rate of preterm premature rupture of membranes than those without cerclage (65.2% vs 36.4%, P <.05).
Cervical cerclage in patients with a short cervix did not reduce the rate of spontaneous preterm delivery and increased the risk of preterm premature rupture of membranes.
我们的目的是确定经阴道超声检查发现宫颈短的女性行宫颈环扎术是否能降低早产率。
一项回顾性队列研究纳入了妊娠14至24周经超声检查发现宫颈短（宫颈长度≤15mm）的患者。宫颈环扎术由主治医师酌情施行。比较了行宫颈环扎术与未行宫颈环扎术患者的临床特征及结局。
70例患者符合纳入标准；25例（36%）接受了宫颈环扎术。与未行宫颈环扎术的患者相比，行宫颈环扎术的患者诊断时的孕周较小（19.6周对21.3周，P<.01），但宫颈长度中位数、漏斗形成情况及宫颈手术史相似。两组间自然早产率无差异。行宫颈环扎术的患者胎膜早破早产率高于未行宫颈环扎术的患者（65.2%对36.4%，P<.05）。
宫颈短的患者行宫颈环扎术并不能降低自然早产率，反而增加了胎膜早破早产的风险。
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