Incerti Maddalena, Ghidini Alessandro, Locatelli Anna, Poggi Sarah H, Pezzullo John C
Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
Am J Obstet Gynecol. 2007 Sep;197(3):315.e1-4. doi: 10.1016/j.ajog.2007.06.029.
The purpose of this study was to evaluate the clinical utility of cerclage in low risk women with cervical length (CL) < or = 25 mm at transvaginal ultrasound (TVU).
This was a retrospective cohort study of women with CL < or = 25 mm identified incidentally at TVU examinations between 16(0/7) to 24(6/7) weeks, with no history of previous preterm birth or midtrimester losses. The primary study outcome was rate of preterm delivery < 35 weeks' gestation.
Women undergoing cerclage placement (n = 31) had shorter CL (P < .001) and lower gestational age at presentation (P < .001) than those managed with rest alone (n = 36). Gestational age at delivery was 37.6 +/- 3.6 vs 38.5 +/- 2.1 weeks (P = .17), and delivery at < 35 weeks occurred in 5/31 versus 2/36 cases, respectively (P = .23). The lack of a significant association between cerclage and rate of delivery < 35 weeks persisted after controlling for gestational age at TVU and initial CL (P = .81).
Cerclage placement does not improve pregnancy outcome in low-risk women with incidental detection of CL < or = 25 mm in the early second trimester.
本研究旨在评估在经阴道超声检查时宫颈长度（CL）≤25mm的低风险女性中，宫颈环扎术的临床效用。
这是一项回顾性队列研究，研究对象为在孕16（0/7）至24（6/7）周经阴道超声检查时偶然发现CL≤25mm、且既往无早产或孕中期流产史的女性。主要研究结局是孕35周前的早产率。
接受宫颈环扎术的女性（n = 31）与仅接受休息治疗的女性（n = 36）相比，CL更短（P <.001），就诊时的孕周更低（P <.001）。分娩时的孕周分别为37.6±3.6周和38.5±2.1周（P =.17），35周前分娩的情况分别发生在5/31例和2/36例中（P =.23）。在控制经阴道超声检查时的孕周和初始CL后，宫颈环扎术与35周前分娩率之间缺乏显著关联这一情况仍然存在（P =.81）。
对于孕中期早期偶然发现CL≤25mm的低风险女性，进行宫颈环扎术并不能改善妊娠结局。
