Benifla J L, Pons J C, Saint Léon M, Hajeri H, Papiernik E
Service de Gynécologie-Obstétrique, Hôpital Antoine-Béclère, Clamart.
J Gynecol Obstet Biol Reprod (Paris). 1990;19(7):851-5.
Authors report a case of peritonitis following uterine cervical cerclage in a patient with twins. This observation leads to two problems: complications of cerclage and its real indications. Two recent controlled studies conclude that in a singleton pregnancy, there is no advantage in cervical cerclage in prolonging the gestation period and in decreasing the perinatal mortality. However, the last MRC/RCOG study, still in progress, shows that in a preliminary study, there is a small advantage in cervical cerclage in high-risk-pregnancy with two previous mid trimester spontaneous abortions and/or with premature labor. In multiple pregnancies especially in twin pregnancy, the problem remains unsolved.
作者报告了一例怀有双胞胎的患者在宫颈环扎术后发生腹膜炎的病例。这一观察结果引发了两个问题:环扎术的并发症及其真正的适应症。最近的两项对照研究得出结论,在单胎妊娠中,宫颈环扎术在延长妊娠期和降低围产期死亡率方面并无优势。然而,仍在进行中的最后一项医学研究委员会/皇家妇产科医师学院的研究表明,在一项初步研究中,对于有两次孕中期自然流产和/或早产史的高危妊娠,宫颈环扎术有微小优势。在多胎妊娠尤其是双胎妊娠中,这个问题仍然没有得到解决。