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[汉诺威医科大学进行的574例宫颈环扎术的适应症及益处(1985 - 1987年)]

[Indication for and benefit of 574 cerclages performed at the Medical University of Hannover (1987-1985)].

作者信息

Böhmer S, Degenhardt F, Oester-Barkey S, Schneider J

机构信息

Frauenklinik der Medizinischen Hochschule Hannover, im Krankenhaus Oststadt.

出版信息

Z Geburtshilfe Perinatol. 1990 Jul-Aug;194(4):158-65.

PMID:2396466
Abstract

574 cervical ligations according to the method of Shirodkar had been performed at the Department of Obstetrics and Gynecology during the years 1978 to 1985. In all cases the "Cervix Set" of Braun-Dexon was used. Compared to the number of 11,397 deliveries in this period, there is a frequency of cerclage operations of about 5%. The average age of the patients had been 29.2 years. Most of the operations had been carried out between the 17th and the 20th and between the 25th and the 30th week of gestation, 20.6% and 34.9%, respectively. 512 women delivered in our hospital, the records of these patients could be evaluated further. 185 women had been primiparae, 225 secundiparae and 102 pluriparae. In a retrospective study the singleton pregnancies (n = 481) had been grouped due to the indication for cerclage: group "obstetric history", group "dilated internal os", group "dilated external cervical os plus decreased cervical length", group "visible fetal membranes" and group "premature contractions plus threatened preterm delivery". Twin and triplet pregnancies (n = 31) had been evaluated separately. Only 48.8% of the multiparae patients had already delivered a viable child, while after cervical ligation 93.9% of the children survived beyond the perinatal phase. Before the 37th week of gestation delivery occurred in only 19.3% of the cases. According to maturity stage of the newborn and to the time period between removal of the cervical ligature and delivery we judged the effectiveness and the necessity of Shirodkar operation in the different patient groups. The results could demonstrate the high importance of this treatment especially in patients with "visible fetal membranes".(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1978年至1985年期间,妇产科按照希罗德卡尔方法进行了574例宫颈环扎术。所有病例均使用了布劳恩 - 德克松的“宫颈套件”。与该时期11397例分娩数量相比,宫颈环扎术的发生率约为5%。患者的平均年龄为29.2岁。大多数手术在妊娠第17至20周以及第25至30周进行,分别占20.6%和34.9%。512名妇女在我院分娩,这些患者的记录可进一步评估。其中初产妇185名,经产妇225名,多产妇102名。在一项回顾性研究中,单胎妊娠(n = 481)根据宫颈环扎术的指征进行分组:“产科病史”组、“宫颈内口扩张”组、“宫颈外口扩张加宫颈长度缩短”组、“可见胎膜”组和“宫缩加先兆早产”组。双胎和三胎妊娠(n = 31)单独评估。只有48.8%的经产妇已分娩存活婴儿,而宫颈环扎术后93.9%的婴儿存活至围产期之后。妊娠37周前分娩的病例仅占19.3%。根据新生儿成熟度阶段以及宫颈结扎拆除与分娩之间的时间段,我们判断了希罗德卡尔手术在不同患者组中的有效性和必要性。结果表明这种治疗方法非常重要,尤其是在“可见胎膜”的患者中。(摘要截断于250字)

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