Aboujaoude Ramzi, Maloof Paul, Alvarez Manuel, Al Khan Abdulla
Department of Obstetrics, Gynecology and Women's Health, Hackensack University Medical Center, Hackensack, New Jersey, USA.
J Reprod Med. 2007 May;52(5):428-30.
Cervical incompetence can lead to the inability to sustain an intrauterine pregnancy and may account for a substantial portion of second-trimester losses. Placement of a transvaginal cerclage has been shown to decrease morbidity in a substantial number of such cases. In patients lacking sufficient cervical tissue, a cerclage may be placed by a transabdominal approach. This procedure carries risks of significant morbidity to the maternal-fetal unit if done by laparotomy.
A 22-year-old gravida at 13 weeks' gestation with a past history significant for cervical incompetence and absence of cervical tissue underwent placement of an abdominal cerclage. We utilized laparoscopic operative techniques and employed hydrodissection to decrease manipulation and bleeding around the gravid uterus.
A laparoscopic approach to cerclage in patients diagnosed with cervical incompetence can be performed with minimal risks to the gravid uterus.
宫颈机能不全可导致无法维持宫内妊娠，可能是孕中期流产的重要原因。经阴道宫颈环扎术已被证明可在大量此类病例中降低发病率。对于宫颈组织不足的患者，可通过经腹途径进行宫颈环扎术。如果通过剖腹手术进行此操作，对母胎单位有显著发病风险。
一名22岁孕13周的孕妇，既往有宫颈机能不全且无宫颈组织的病史，接受了经腹宫颈环扎术。我们采用了腹腔镜手术技术并进行水分离术，以减少对妊娠子宫周围的操作和出血。
对于诊断为宫颈机能不全的患者，采用腹腔镜途径进行宫颈环扎术对妊娠子宫的风险最小。
