Berghella Vincenzo, Seibel-Seamon Jolene
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Clin Obstet Gynecol. 2007 Jun;50(2):468-77. doi: 10.1097/GRF.0b013e31804bddfd.
Although it was devised over 50 years ago, only recently controlled randomized trials have evaluated the efficacy of cervical cerclage. Cerclage was originally devised for women with both prior preterm birth (PTB) and cervical changes in the current pregnancy. Evidence suggests that transvaginal cerclage probably prevents second trimester loss/PTB in women with >or=3 PTB/second trimester loss (history-indicated cerclage best placed at 12 to 14 wk); and in women with a prior PTB 16 to 36 weeks and transvaginal ultrasound cervical length<25 mm in the current pregnancy (ultrasound-indicated cerclage at 14 to 23 6/7 wk).
尽管宫颈环扎术是在50多年前设计出来的，但直到最近才有对照随机试验对其疗效进行评估。宫颈环扎术最初是为既往有早产史且本次妊娠宫颈有变化的女性设计的。有证据表明，经阴道宫颈环扎术可能会预防有≥3次早产/孕中期流产史的女性发生孕中期流产/早产（既往史指征性宫颈环扎术最佳时机为孕12至14周）；以及既往有16至36周早产史且本次妊娠经阴道超声测量宫颈长度<25 mm的女性发生早产（超声指征性宫颈环扎术时机为孕14至23 6/7周）。
