Sumners J E, Moore E S, Ramsey C J, Eggleston M K
St. Vincent Women's Hospital.
J Obstet Gynaecol. 2011;31(2):111-7. doi: 10.3109/01443615.2010.542512.
There are no reports indicating the effect of prophylactic transabdominal cerclage (TAC) on the prolongation of multifetal pregnancies. We report the use of TAC in triplets, which evolved over 20 years in one practice. A retrospective cohort study of triplet pregnancies was conducted. Obstetric and neonatal outcomes were compared among women who underwent a prophylactic TAC or transvaginal cerclage and no cerclage. Of the 141 women who delivered triplets, prophylactic TAC was associated with reduced incidence of extreme prematurity and improved incidence of neonatal/postnatal survival. With the exception of mode of conception, prepregnancy weight, and the use of home monitoring uterine activity monitor, procardia and terbutaline, no major differences were found in terms of patient characteristics and pregnancy and delivery management among the three groups. It was concluded that in triplet pregnancies, prophylactic placement of a TAC appears to lower the incidence of delivery before 28 weeks.
尚无报告表明预防性经腹宫颈环扎术（TAC）对多胎妊娠延长的影响。我们报告了三胎妊娠中TAC的使用情况，这是在一个医疗机构中历经20年发展而来的。对三胎妊娠进行了一项回顾性队列研究。比较了接受预防性TAC或经阴道宫颈环扎术以及未行宫颈环扎术的女性的产科和新生儿结局。在141例分娩三胞胎的女性中，预防性TAC与极低早产发生率降低及新生儿/产后存活率提高相关。除受孕方式、孕前体重以及是否使用家庭监测子宫活动监测仪、硝苯地平和特布他林外，三组在患者特征以及妊娠和分娩管理方面未发现重大差异。得出的结论是，在三胎妊娠中，预防性放置TAC似乎可降低28周前分娩的发生率。
