Fox Nathan S, Rebarber Andrei, Bender Samuel, Saltzman Daniel H
Maternal Fetal Medicine Associates, PLLC, 70 East 90th Street, New York, NY 10128, USA.
J Reprod Med. 2009 Jun;54(6):361-5.
To describe labor outcomes in women who had a Shirodkar cerclage placed during pregnancy and removed before labor.
A review was conducted of 69 patients with a singleton pregnancy and a Shirodkar cervical cerclage placed before 24 weeks' gestation. Indications for cerclage were history indicated, ultrasound indicated or physical examination indicated.
The mean time from cerclage removal to delivery was 9.4 +/- 8.8 days. The overall cesarean delivery rate was 18.8%, with the majority (9 of 13) being for fetal indications. Two (2.9%) patients had a uterine rupture of an unscarred uterus and 2 (2.9%) patients had an umbilical cord prolapse. Four (5.8%) patients had a cervical laceration requiring repair.
Patients with a Shirodkar cerclage placed and removed during the index pregnancy appear to have a higher than expected rate of cesarean delivery for fetal indications and complications associated with significant neonatal morbidity including uterine rupture and cord prolapse.
描述孕期接受希罗德卡尔宫颈环扎术并在临产前拆除缝线的女性的分娩结局。
对69例单胎妊娠且在妊娠24周前接受希罗德卡尔宫颈环扎术的患者进行回顾性研究。环扎术的指征包括病史提示、超声提示或体格检查提示。
从拆除缝线至分娩的平均时间为9.4±8.8天。总体剖宫产率为18.8%，其中大多数（13例中的9例）是因胎儿指征。2例（2.9%）患者发生了未瘢痕化子宫的子宫破裂，2例（2.9%）患者发生了脐带脱垂。4例（5.8%）患者有需要修补的宫颈裂伤。
在本次妊娠期间接受并拆除希罗德卡尔宫颈环扎术的患者，因胎儿指征行剖宫产的发生率以及与包括子宫破裂和脐带脱垂在内的显著新生儿发病率相关的并发症发生率似乎高于预期。
