Golan A, Langer R, Wexler S, Segev E, Niv D, David M P
Department of Obstetrics & Gynecology, Assaf Harofe Medical Centre, Zerifin, Israel.
Int J Fertil. 1990 May-Jun;35(3):164-70.
Twenty-nine cases of cervical incompetence were found among 98 women diagnosed as having a congenital uterine anomaly on hysterosalpingography, a high incidence of 30%. The highest incidence was found in the bicornuate uterus group--38%. The incidence of premature delivery and late abortion was higher in this group than in the rest of the patients with uterine anomalies (55% and 68%, vs. 45% and 32%). An obvious improvement in obstetrical performance was noted after cerclage. In the cervical incompetence group, term deliveries increased from 26% to 63%. Premature deliveries and late abortions dropped from 74% to 37%. Even in the patients with anomalous uterus without proven diagnosis of cervical incompetence, term deliveries increased from 64% to 96%, and pregnancies terminating prematurely dropped from 35.6% to 4%, following cerclage. No doubt exists as to the need for cerclage in cases of cervical incompetence. We also believe it should be performed prophylactically in cases of bicornuate uterus. The concept of routine prophylactic cerclage in all cases of uterine anomalies should be considered.
在98例子宫输卵管造影诊断为先天性子宫异常的女性中，发现29例宫颈机能不全，发生率高达30%。双角子宫组的发生率最高，为38%。该组早产和晚期流产的发生率高于其他子宫异常患者（分别为55%和68%，而其他患者为45%和32%）。宫颈环扎术后产科结局有明显改善。在宫颈机能不全组，足月分娩率从26%升至63%。早产和晚期流产率从74%降至37%。即使在未确诊宫颈机能不全的子宫异常患者中，宫颈环扎术后足月分娩率也从64%升至96%，早产率从35.6%降至4%。宫颈机能不全病例进行宫颈环扎的必要性毋庸置疑。我们也认为双角子宫病例应进行预防性宫颈环扎。应考虑对所有子宫异常病例进行常规预防性宫颈环扎的概念。
