Shivani Durai, Quek Bin Huey, Tan Pih Lin, Shephali Tagore
Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore, Tel.: +65 97366679.
Department of Neonatology, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
J Perinat Med. 2018 Oct 25;46(8):876-880. doi: 10.1515/jpm-2017-0311.
Rescue cervical cerclage (RCC), also known as emergency cerclage, has long been the subject of controversy. Its use in women who have a dilated cervix has been ambivalent. RCC is often considered as a salvage measure for pregnancies which are at a high risk of severe preterm delivery (PTD) or mid-trimester miscarriage. This study aims to examine and assess the efficacy of RCC and its ability to prolong pregnancy until neonatal viability is achieved. The current data suggest that RCC is associated with a longer latency period frequently resulting in better pregnancy outcomes (Namouz S, Porat S, Okun N, Windrim R, Farine D. Emergency cerclage: literature review. Obstet Gynecol Surv. 2013;68:379-88). This is supported by the Royal College of Obstetricians and Gynaecologists (RCOG) which states that the insertion of a rescue cerclage may delay delivery by a further 5 weeks on average as compared with expectant management or bed rest alone (Shennan AH. To MS: RCOG Green Top Guidelines: Cervical Cerclage RCOG.2011. Available from: www.rcog.org.uk). It further states that it may be associated with a two-fold reduction in the possibility of delivery before 34 weeks of gestation (Shennan AH. To MS: RCOG Green Top Guidelines: Cervical Cerclage RCOG.2011. Available from: www.rcog.org.uk). Our study reveals that the average insertion to delivery interval at our centre was 71.2 days with a live birth rate of 92.5%. A total of 89.1% of women delivered beyond 24 weeks of gestation.
紧急宫颈环扎术（RCC），也称为急诊宫颈环扎术，长期以来一直是争议的焦点。其在宫颈扩张女性中的应用一直存在争议。紧急宫颈环扎术通常被视为对有严重早产（PTD）或孕中期流产高风险妊娠的一种挽救措施。本研究旨在检查和评估紧急宫颈环扎术的疗效及其延长妊娠至新生儿存活的能力。目前的数据表明，紧急宫颈环扎术与较长的潜伏期相关，这通常会带来更好的妊娠结局（Namouz S，Porat S，Okun N，Windrim R，Farine D.急诊宫颈环扎术：文献综述。《妇产科临床观察》。2013；68：379 - 88）。英国皇家妇产科医师学院（RCOG）也支持这一点，该学院指出，与单纯期待治疗或卧床休息相比，插入紧急宫颈环扎术平均可使分娩延迟5周（Shennan AH.To MS：RCOG绿色指南：宫颈环扎术RCOG.2011.可从：www.rcog.org.uk获取）。它还指出，这可能使妊娠34周前分娩的可能性降低两倍（Shennan AH.To MS：RCOG绿色指南：宫颈环扎术RCOG.2011.可从：www.rcog.org.uk获取）。我们的研究表明，我们中心从插入到分娩的平均间隔为71.2天，活产率为92.5%。共有89.1%的女性在妊娠24周后分娩。
