[孕中期宫颈长度小于25毫米的双胎早产预防——阿拉伯式宫颈环扎 pessary与阴道内微粉化孕酮联合治疗与保守治疗的比较]

[PREVENTION OF PRETERM BIRTH IN TWINS WITH SHORT MID-TRIMESTER CERVICAL LENGTH LESS THAN 25MM -COMBINED TREATMENT WITH ARABIN'S CERCLAGE PESSARY AND INTRAVAGINAL MICRONIZED PROGESTERONE COMPARED WITH CONSERVATIVE TREATMENT].

作者信息

Zimerman Ariel, Maymon Ron, Viner Yfat, Glick Noa, Herman Arie, Neeman Ortal

机构信息

Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center affiliated with the Tel Aviv University, Sacker Faculty of Medicine, Zerifin, Israel.

出版信息

Harefuah. 2018 May;157(5):301-304.

PMID:29804334

Abstract

BACKGROUND

Twin pregnancies with short mid-trimester cervical length have a high rate of preterm births.

OBJECTIVES

To compare combined treatment of Arabin cerclage pessary, and intravaginal micronized progesterone to conservative treatment for the prevention of preterm births in twins pregnancies with short cervical length in second trimester of pregnancy.

METHODS

A retrospective study that compared twin pregnancies with short ≤25mm cervix in second trimester 16-28 gestational weeks treated with combined treatment of Arabin cervical pessary and intravaginal micronized progesterone 200mg TID to a control group with conservative treatment for the prevention of preterm.

RESULTS

The treatment group included 32 patients and the control group 26 patients. Average week at admission was 23 ± 2.2 vs 25 ±3.1 weeks, average cervical length at admission 14.1 ± 2.2 mm vs 13 ±2.1 mm respectively. Average week of delivery 34.4 ±3.9 vs. 33.4 ±4.1, p=0.6 and incidence of delivery ≤28weeks was 9.4% vs. 34% p=0.04.

CONCLUSIONS

The treatment group had a lower incidence of preterm birth before 28 weeks. Further prospective studies are needed to assess preterm birth prevention treatments efficacy and the use of Arabin cervical pessary in twins.

摘要