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There is insufficient evidence to claim that cerclage is the treatment of choice for patients with a cervical length <10 mm.

作者信息

Romero Roberto, Conde-Agudelo Agustin, Nicolaides Kypros H

机构信息

Chief, Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI.

Director, Division of Epidemiology, Systematic Reviews, and Meta-analyses, Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI.

出版信息

Am J Obstet Gynecol. 2018 Aug;219(2):213-215. doi: 10.1016/j.ajog.2018.04.009. Epub 2018 Apr 12.

DOI:10.1016/j.ajog.2018.04.009
PMID:29654737
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6105270/
Abstract
摘要

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1
There is insufficient evidence to claim that cerclage is the treatment of choice for patients with a cervical length <10 mm.没有足够的证据表明宫颈环扎术是宫颈长度小于10毫米患者的首选治疗方法。
Am J Obstet Gynecol. 2018 Aug;219(2):213-215. doi: 10.1016/j.ajog.2018.04.009. Epub 2018 Apr 12.
2
Perhaps cerclage is the ideal treatment for the cervix <1 cm.对于宫颈长度小于1厘米的情况，环扎术或许是理想的治疗方法。
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Cervical cerclage in the prevention of preterm birth.宫颈环扎术预防早产
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[Clinical outcome of therapeutic cervical cerclage in short cervix syndrome].
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Role of Cervical Cerclage and Vaginal Progesterone in the Treatment of Cervical Incompetence with/without Preterm Birth History.宫颈环扎术与阴道用孕激素在治疗有无早产史的宫颈机能不全中的作用
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A multi-centre, non-inferiority, randomised controlled trial to compare a cervical pessary with a cervical cerclage in the prevention of preterm delivery in women with short cervical length and a history of preterm birth - PC study.一项多中心、非劣效性、随机对照试验，比较宫颈托与宫颈环扎术在预防宫颈长度短且有早产史的女性早产中的效果——PC研究。
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引用本文的文献

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Relationship of Amniotic Fluid Sludge and Short Cervix With a High Rate of Preterm Birth in Women After Cervical Cerclage.宫颈环扎术后孕妇羊水中有胎粪与短宫颈与早产发生率高的关系。
J Ultrasound Med. 2022 Nov;41(11):2687-2693. doi: 10.1002/jum.15952. Epub 2022 Feb 2.
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Cervical pessary to prevent preterm birth in asymptomatic high-risk women: a systematic review and meta-analysis.宫颈托预防无症状高危孕妇早产的系统评价和荟萃分析。
Am J Obstet Gynecol. 2020 Jul;223(1):42-65.e2. doi: 10.1016/j.ajog.2019.12.266. Epub 2020 Feb 3.
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Antibiotic administration can eradicate intra-amniotic infection or intra-amniotic inflammation in a subset of patients with preterm labor and intact membranes.抗生素的应用可以消除一部分胎膜完整的早产患者的羊膜内感染或羊膜内炎症。
Am J Obstet Gynecol. 2019 Aug;221(2):142.e1-142.e22. doi: 10.1016/j.ajog.2019.03.018. Epub 2019 Mar 27.
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Evidence that antibiotic administration is effective in the treatment of a subset of patients with intra-amniotic infection/inflammation presenting with cervical insufficiency.有证据表明，对于部分因宫颈机能不全而出现羊膜腔内感染/炎症的患者，抗生素治疗是有效的。
Am J Obstet Gynecol. 2019 Aug;221(2):140.e1-140.e18. doi: 10.1016/j.ajog.2019.03.017. Epub 2019 Mar 28.

本文引用的文献

1
Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data.阴道用孕激素预防短宫颈单胎妊娠早产及不良围产结局：一项个体患者数据的荟萃分析。
Am J Obstet Gynecol. 2018 Feb;218(2):161-180. doi: 10.1016/j.ajog.2017.11.576. Epub 2017 Nov 17.
2
Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta-analysis of randomized controlled trials using individual patient-level data.超声检查宫颈短的单胎妊娠孕妇行环扎术以预防自发性早产史：使用个体患者水平数据的随机对照试验的系统评价和荟萃分析。
Ultrasound Obstet Gynecol. 2017 Nov;50(5):569-577. doi: 10.1002/uog.17457. Epub 2017 Oct 5.
3
17 Alpha-hydroxyprogesterone caproate for preterm prevention: issues in subgroup analysis.己酸17α-羟孕酮用于预防早产：亚组分析中的问题。
Am J Obstet Gynecol. 2016 Mar;214(3):306-7. doi: 10.1016/j.ajog.2015.12.002.
4
Vaginal progesterone to prevent preterm birth in pregnant women with a sonographic short cervix: clinical and public health implications.超声检查发现宫颈短的孕妇使用阴道孕酮预防早产：临床及公共卫生意义
Am J Obstet Gynecol. 2016 Feb;214(2):235-242. doi: 10.1016/j.ajog.2015.09.102. Epub 2015 Oct 9.