Uzun Cilingir Isil, Sayin Cenk, Sutcu Havva, İnan Cihan, Erzincan Selen, Yener Cem, Varol Fusun
Trakya University, Faculty of Medicine, Department of Perinatology, Edirne, Turkey.
Trakya University, Faculty of Medicine, Department of Perinatology, Edirne, Turkey.
J Gynecol Obstet Hum Reprod. 2019 Jun;48(6):387-390. doi: 10.1016/j.jogoh.2019.01.002. Epub 2019 Jan 8.
To asses the efectivity of emergency cerclage in the patients with advance cervical dilatation and prolapsed membranes.
The patients who have ≥4 cm cervical dilatation with protruding membranes were included in the study. The patients were divided into two groups. Group I was consisted of the patients who had emergency cerclage procedure and group II was consisted of the patients who denied the operation and expectantly managed. The physical examination, pregnancy outcomes and the complications were compared between the groups. The results of the patients with emergency cerclage were analysed.
21 patients were referred with a ≥4 cm cervical dilatation with protruding membranes 33.3% of women with emergency cerclage were delivered within one week from the admission. One patient, who was a grand multiparous (G6P4A1), was delivered a healthy infant at 40 weeks of gestation. The remaining five patients were delivered between 21 and 24 weeks, but all the infants were died due to extreme prematurity.Two patients (22.2%) developed chorioamnionitis that necessitated long hospitalization (14-21 days). In group II (expectant management) 83,3% of the patients were delivered within the 48 h from the admission. There were no case of chorioamnionitis in group II.
Emergency cervical cerclage is not a rationale option for the patients with an advanced cervical dilation (>4 cm) together with protruding membranes in early second trimester because of the short prolongation time and high complication rate.
评估紧急宫颈环扎术对宫颈扩张进展且胎膜脱垂患者的有效性。
纳入宫颈扩张≥4cm且胎膜突出的患者进行研究。将患者分为两组。第一组为接受紧急宫颈环扎术的患者，第二组为拒绝手术并进行期待治疗的患者。比较两组患者的体格检查、妊娠结局及并发症情况。分析接受紧急宫颈环扎术患者的结果。
21例患者因宫颈扩张≥4cm且胎膜突出前来就诊。接受紧急宫颈环扎术的患者中，33.3%在入院后一周内分娩。1例经产妇（G6P4A1）在妊娠40周时产下一名健康婴儿。其余5例患者在21至24周分娩，但所有婴儿均因极度早产死亡。2例患者（22.2%）发生绒毛膜羊膜炎，需要长时间住院（14 - 21天）。在第二组（期待治疗组）中，83.3%的患者在入院后48小时内分娩。第二组无绒毛膜羊膜炎病例。
对于孕中期早期宫颈扩张进展（>4cm）且胎膜突出的患者，紧急宫颈环扎术并非合理选择，因为延长孕周时间短且并发症发生率高。
