Costa Maíra Marinho Freire, Amorim Filho Antonio Gomes de, Barros Mônica Fairbanks de, Rodrigues Agatha Sacramento, Zugaib Marcelo, Francisco Rossana Pulcineli Vieira, Carvalho Mário Henrique Burlacchini de
Department of Obstetrics and Gynecology, University of São Paulo Medical School, São Paulo, Brasil.
Rev Assoc Med Bras (1992). 2019 Jun 3;65(5):598-602. doi: 10.1590/1806-9282.65.5.598.
The gestational and neonatal outcomes of women with early cervical dilatation undergoing emergency cerclage were evaluated and compared with women treated with expectant management and bed rest.
Retrospective analysis of pregnant women admitted between 2001 and 2017 with a diagnosis of early cervical dilatation and/or bulging membranes. Patients with a singleton pregnancy of a fetus without malformations, between 16 and 25 weeks and 6 days, with cervical dilatation of 1 to 3 cm were included; patients who delivered or miscarried within 2 days after admission were excluded.
The study enrolled 30 patients: 19 in the cerclage group and 11 in the rest group. There was a significant difference, with the cerclage group showing better results concerning gestational age at delivery (28.7 vs. 23.3 weeks; p=0.031) and latency between hospital admission and delivery (48.6 vs. 16 days; p=0.016). The fetal death rate was lower in the cerclage group (5.3% vs. 54.5%, p=0.004). Considering gestational age at delivery of live newborns, no difference was observed between the cerclage and rest groups (29.13 vs. 27.4 weeks; p=0.857).
Emergency cerclage was associated with longer latency, a significant impact on gestational age at delivery and reduction in the fetal death rate.
对接受紧急宫颈环扎术的宫颈过早扩张女性的妊娠及新生儿结局进行评估，并与接受期待治疗和卧床休息的女性进行比较。
回顾性分析2001年至2017年期间收治的诊断为宫颈过早扩张和/或胎膜膨出的孕妇。纳入单胎妊娠、胎儿无畸形、孕16周0天至25周6天、宫颈扩张1至3 cm的患者；排除入院后2天内分娩或流产的患者。
该研究纳入30例患者：宫颈环扎组19例，其余组11例。两组间存在显著差异，宫颈环扎组在分娩孕周（28.7周对23.3周；p = 0.031）及入院至分娩间隔时间（48.6天对16天；p = 0.016）方面结果更好。宫颈环扎组的胎儿死亡率更低（5.3%对54.5%，p = 0.004）。就存活新生儿的分娩孕周而言，宫颈环扎组与其余组之间未观察到差异（29.13周对27.4周；p = 0.857）。
紧急宫颈环扎术与更长的间隔时间、对分娩孕周有显著影响以及胎儿死亡率降低相关。
