Zhu Li-Qiong, Chen Hui, Chen Li-Bin, Liu Ying-Lin, Tian Jian-Ping, Wang Yun-Hui, Zhang Rui, Zhang Jian-Ping
Department of Obstetrics and Gynecology, un Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China (mainland).
Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China (mainland).
Med Sci Monit. 2015 May 15;21:1395-401. doi: 10.12659/MSM.893244.
The aim of this study was to evaluate the effectiveness and safety of emergency cervical cerclage in women with advanced cervical dilatation and bulging of fetal membranes. The study included 158 women who underwent emergency cervical cerclage because of cervix dilatation and protruding membranes in mid-trimester at Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Pregnancy outcomes and pregnancy outcome related to clinical features were analyzed retrospectively. Analysis revealed that the placement of emergency cerclage led to the delivery of live infants with a success rate of 82.28%. The mean interval between cerclage and delivery was 52.16.±26.62 days, with a mean gestation at delivery of 30.3±4.7 weeks and a mean birth weight of 1934.69±570.37 g. No severe maternal complications such as maternal death, hematosepsis, and hysterorrhexis occurred after the operation. Two women (1.25%) had laceration of the cervix, 1 woman (0.61%) suffered pulmonary edema, and 2 women (1.25%) developed deep vein thrombosis (DVT). There were significant correlations between the pregnancy outcome and risk factors, including any presenting symptoms, cervical dilatation, postoperative white blood cell count, and C-reactive protein (CRP) value. No significant difference was found in women with good vs. poor outcome in terms of maternal age and obstetric histories. Emergency cervical cerclage is effective in prolonging pregnancy and improving neonatal outcome in women with cervical incompetence. It should be considered a viable option for women with a dilated cervix in mid-trimester.
本研究的目的是评估紧急宫颈环扎术对宫颈扩张且胎膜膨出的女性的有效性和安全性。该研究纳入了158例因孕中期宫颈扩张和胎膜膨出而接受紧急宫颈环扎术的女性，这些女性来自中山大学孙逸仙纪念医院。对妊娠结局以及与临床特征相关的妊娠结果进行了回顾性分析。分析显示，紧急环扎术使活产婴儿的分娩成功率达到82.28%。环扎术至分娩的平均间隔时间为52.16±26.62天，分娩时的平均孕周为30.3±4.7周，平均出生体重为1934.69±570.37克。术后未发生严重的母体并发症，如产妇死亡、败血症和子宫破裂。2名女性（1.25%）发生宫颈裂伤，1名女性（0.61%）出现肺水肿，2名女性（1.25%）发生深静脉血栓形成（DVT）。妊娠结局与危险因素之间存在显著相关性，这些危险因素包括任何出现的症状、宫颈扩张、术后白细胞计数和C反应蛋白（CRP）值。在产妇年龄和产科病史方面，妊娠结局良好与不良的女性之间未发现显著差异。紧急宫颈环扎术对于延长宫颈机能不全女性的孕周和改善新生儿结局是有效的。对于孕中期宫颈扩张的女性，应将其视为一种可行的选择。
