Golfier F, Bessai K, Paparel P, Cassignol A, Vaudoyer F, Raudrant D
Department of Obstetrics and Gynaecology, Hôtel-Dieu, 69002 Lyon, France.
Eur J Obstet Gynecol Reprod Biol. 2001 Dec 10;100(1):16-21. doi: 10.1016/s0301-2115(01)00444-4.
To analyse the foetal outcome after transvaginal cervicoisthmic cerclage, to determine whether it is a valid alternative to the reference transabdominal technique.
Description of the vaginal operative technique, retrospective review of 20 cervicoisthmic cerclage patients from 1990 to 2000.
In the curative group of women with a history of late pregnancy losses or premature deliveries and usually previous failed classical cervical cerclage, the foetal survival rate improved from 18% before cerclage to 79% after cerclage. No operative complications were reported. In the prophylactic group, typically characterised by the absence of the cervix as a consequence of surgery for invasive cervical cancers, the foetal survival rate was 83% after cerclage.
The transvaginal cervicoisthmic cerclage allows a high foetal survival rate without complications in highly selected patients with poor obstetrical history. Because of its simplicity, this technique should replace the transabdominal route for surgeons experienced in vaginal surgery.
分析经阴道宫颈峡部环扎术后的胎儿结局，以确定其是否为传统经腹技术的有效替代方法。
描述阴道手术技术，回顾性分析1990年至2000年期间20例行宫颈峡部环扎术的患者。
在有晚期妊娠丢失或早产史且既往经典宫颈环扎术通常失败的治疗组中，胎儿存活率从环扎术前的18%提高到环扎术后的79%。未报告手术并发症。在预防性组中，典型特征是因浸润性宫颈癌手术导致宫颈缺失，环扎术后胎儿存活率为83%。
经阴道宫颈峡部环扎术在产科病史不良的高度选择患者中可实现高胎儿存活率且无并发症。由于其操作简单，对于有阴道手术经验的外科医生而言，该技术应取代经腹途径。
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