Woensdregt Karlijn, Norwitz Errol R, Cackovic Michael, Paidas Michael J, Illuzzi Jessica L
Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.
Am J Obstet Gynecol. 2008 Apr;198(4):396.e1-7. doi: 10.1016/j.ajog.2007.10.782. Epub 2008 Feb 21.
This study investigates whether 2 cerclage stitches are more effective than 1 stitch in the prevention of preterm birth.
This is a retrospective cohort study of 150 singleton pregnancies that underwent cervical cerclage. Gestational age at delivery and clinical characteristics were compared.
One hundred twelve patients (74.7%) received 1 stitch, and 38 patients (25.3%) received 2 stitches. There were no baseline differences between the groups. Analysis showed no significant difference in gestational age at delivery between the 1 vs 2 cerclage groups overall (median, 38.0 vs 38.3 weeks of gestation, respectively; P = .356) or for a given gestational age cut-off (<37 weeks of gestation: 37.4% vs 34.2% [P = .727]; <34 weeks of gestation: 16.8% vs 18.4% [P = .823]; <28 weeks of gestation: 9.4% vs 2.6% [P = .179]).
This study shows no measurable benefit to the placement of 2 stitches over 1 stitch during cervical cerclage in singleton pregnancies; however, further study of preterm birth at <28 weeks of gestation and postcerclage outcomes among a larger cohort is merited.
本研究调查在预防早产方面,2 针宫颈环扎术是否比 1 针更有效。
这是一项对 150 例接受宫颈环扎术的单胎妊娠进行的回顾性队列研究。比较了分娩时的孕周和临床特征。
112 例患者(74.7%)接受了 1 针环扎,38 例患者(25.3%)接受了 2 针环扎。两组之间无基线差异。分析显示,总体上,1 针与 2 针环扎组在分娩时的孕周无显著差异(中位数分别为 38.0 周和 38.3 周;P = 0.356),对于给定的孕周截断值也是如此(孕周<37 周:37.4%对 34.2%[P = 0.727];孕周<34 周:16.8%对 18.4%[P = 0.823];孕周<28 周:9.4%对 2.6%[P = 0.179])。
本研究表明,在单胎妊娠的宫颈环扎术中,2 针环扎并不比 1 针环扎有可测量的益处;然而,对于孕周<28 周的早产及更大队列中环扎术后结局进行进一步研究是有必要的。