Yassaee Fakhrolmolouk, Mostafaee Leila
Department of Gynecology and Obstetries, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Reprod Infertil. 2011 Oct;12(4):277-9.
Congenital uterine malformations are the result of disturbances in mullerian duct development. In patients with recurrent miscarriage, the reported frequency of uterine anomalies varies widely, from 1.8% to 37.6%. There are reports in which cervical cerclage has been shown to prevent preterm labor in uterine anomalies. The aim of this study was to compare the role of cervical cerclage in the pregnancy outcome of women with uterine anomaly.
In this historical cohort study, 40 pregnant women with uterine anomaly were investigated for outcomes of pregnancy in regards to preterm and term deliveries. The participants were divided into two groups: the case group included 26 women with uterine anomaly for whom cervical cerclage was done and the control group was composed of 14 women with uterine anomaly in whom cervical cerclage was not performed. Comparison between the two groups was done and the data were analyzed by the use of chi square, Fisher's exact test and t-test with SPSS software (version 11) and p <0.05 was considered significant.
In patients with bicornuate uterus and cervical cerclage, term delivery occurred in 76.2% and preterm delivery in 23.8%. In patients with bicornuate uterus and without cervical cerclage, term delivery occurred in 27.3% and preterm delivery in 72.7% (p <0.05). In patients with arcuate uterus and cervical cerclage, term and preterm deliveries were equal (50% vs. 50%), but in patients with arcuate uterus and without cervical cerclage, term and preterm deliveries occurred in 66.6% and 33.3% of the participants, respectively.
Cervical cerclage is an effective procedure in bicornuate uterus for the prevention of preterm deliveries but it has no effect on the outcome of pregnancy in arcuate uterus.
先天性子宫畸形是苗勒管发育异常的结果。在复发性流产患者中，所报道的子宫异常发生率差异很大，从1.8%到37.6%不等。有报道显示宫颈环扎术可预防子宫异常患者的早产。本研究的目的是比较宫颈环扎术在子宫异常女性妊娠结局中的作用。
在这项历史性队列研究中，对40例子宫异常的孕妇进行了早产和足月分娩方面的妊娠结局调查。参与者被分为两组：病例组包括26例行宫颈环扎术的子宫异常女性，对照组由14例未行宫颈环扎术的子宫异常女性组成。对两组进行比较，并使用SPSS软件（11版）通过卡方检验、Fisher精确检验和t检验分析数据，p<0.05被认为具有统计学意义。
双角子宫且行宫颈环扎术的患者中，足月分娩率为76.2%，早产率为23.8%。双角子宫且未行宫颈环扎术的患者中，足月分娩率为27.3%，早产率为72.7%（p<0.05）。弓形子宫且行宫颈环扎术患者的足月和早产率相等（分别为50%和50%），但弓形子宫且未行宫颈环扎术的患者中，足月和早产率分别为66.6%和33.3%。
宫颈环扎术对双角子宫预防早产是一种有效的方法，但对弓形子宫的妊娠结局没有影响。
