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宫颈环扎术与非宫颈环扎术病例中延迟间隔分娩的产科和新生儿结局:20例多胎妊娠分析

Obstetric and neonatal outcomes of delayed interval delivery in cerclage and non-cerclage cases: an analysis of 20 multiple pregnancies.

作者信息

Doger Emek, Cakiroglu Yigit, Ceylan Yasin, Kole Emre, Ozkan Sebiha, Caliskan Eray

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Kocaeli University, Kocaeli, Turkey.

出版信息

J Obstet Gynaecol Res. 2014 Jul;40(7):1853-61. doi: 10.1111/jog.12435.

Abstract

AIM

The aim of study is to compare maternal and fetal outcomes of pregnancies in which cerclage was placed following the loss of first fetus with those without cerclage placement in multiple pregnancies for delayed interval delivery.

METHODS

Records of pregnancies in which the first fetus was lost between 13-26 weeks and delayed delivery experienced for retained fetus(es), were collected retrospectively. A total of 20 patients including 11 twins, seven triplets and two quadruplets were evaluated. Cases with cervical cerclage placed after the first delivery were evaluated as the cerclage group (n = 11) and the cases without cerclage placement were evaluated as the non-cerclage group (n = 9).

RESULTS

Median duration of delay was 22 days (range, 3-121) for both groups; 40 days (range, 5-121) in cerclage group and 12 days (range, 3-46) in the non-cerclage group (P = 0.003). Average birthweight of retained fetus(es) in the cerclage group was 850 ± 153.6 g (mean ± standard error [SE]) and 549.5 ± 149.1 g (mean ± SE) in the non-cerclage group (P = 0.04). Delivery week of retained fetus(es), live birth rate, take-home baby rate and chorioamnionitis ratio were not different in between the groups.

CONCLUSION

Cervical cerclage after the first delivery is associated with a longer delivery interval and higher birthweight of retained fetus.

摘要

目的

本研究旨在比较多胎妊娠中首例胎儿丢失后行宫颈环扎术与未行宫颈环扎术以延迟间隔分娩的母婴结局。

方法

回顾性收集首例胎儿在孕13 - 26周丢失且因保留胎儿而延迟分娩的妊娠记录。共评估了20例患者,包括11例双胎、7例三胎和2例四胎。将首次分娩后行宫颈环扎术的病例评估为环扎组(n = 11),未行宫颈环扎术的病例评估为非环扎组(n = 9)。

结果

两组延迟的中位时长均为22天(范围3 - 121天);环扎组为40天(范围5 - 121天),非环扎组为12天(范围3 - 46天)(P = 0.003)。环扎组保留胎儿的平均出生体重为850 ± 153.6 g(均值±标准误[SE]),非环扎组为549.5 ± 149.1 g(均值±SE)(P = 0.04)。两组间保留胎儿的分娩孕周、活产率、带回家婴儿率和绒毛膜羊膜炎发生率无差异。

结论

首次分娩后行宫颈环扎术与更长的分娩间隔及保留胎儿更高的出生体重相关。

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