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改良腹腔镜经腹宫颈峡部环扎术治疗宫颈因素所致复发性流产的手术管理

Modified Laparoscopic Transabdominal Cervicoisthmic Cerclage for the Surgical Management of Recurrent Pregnancy Loss due to Cervical Factors.

作者信息

Chung Hyewon, Lee Seungmee, Song Changho, Jang Tae-Kyu, Bae Jin-Gon, Kwon Sang-Hoon, Shin So-Jin, Cho Chi-Heum

机构信息

Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Korea.

Comprehensive Care Center for High Risk Pregnancy and Newborn, Keimyung University Dongsan Hospital, Daegu 42601, Korea.

出版信息

J Clin Med. 2021 Feb 10;10(4):693. doi: 10.3390/jcm10040693.

Abstract

This study aimed evaluate the feasibility of modified laparoscopic transabdominal cervicoisthmic cerclage (LTCC) and its impact on recurrent pregnancy loss (RPL) and is a retrospective observational cohort study of patients who underwent modified LTCC from 2003 to 2018 (n = 299). The surgery was performed at a mean gestational age of 12.5 weeks (range 10.5-17.5 weeks). Of the 299 patients, 190 were reported as having undergone abortion (one abortion: 91 (47.9%), two: 59 (31.1%), three or more: 40 (21.1%)) before the present pregnancy and prior to the surgery. The mean operation time was 47.4 min (range 15-100 min). We followed up with 205 of 299 patients and recorded their obstetric outcomes. There were 176 successful deliveries via cesarean section, and the fetal survival rate was 85.9% (176/205). The results of this study suggest that modified LTCC is a safe and feasible surgical option during pregnancy for patients with a history of RPL due to cervical factors.

摘要

本研究旨在评估改良腹腔镜经腹宫颈峡部环扎术(LTCC)的可行性及其对复发性流产(RPL)的影响,是一项对2003年至2018年接受改良LTCC手术的患者(n = 299)进行的回顾性观察队列研究。手术在平均孕龄12.5周(范围10.5 - 17.5周)时进行。在299例患者中,190例报告在本次妊娠及手术前有流产史(一次流产:91例(47.9%),两次:59例(31.1%),三次或更多次:40例(21.1%))。平均手术时间为47.4分钟(范围15 - 100分钟)。我们对299例患者中的205例进行了随访,并记录了他们的产科结局。有176例通过剖宫产成功分娩,胎儿存活率为85.9%(176/205)。本研究结果表明,对于因宫颈因素导致复发性流产病史的患者,改良LTCC是孕期一种安全可行的手术选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2402/7916712/09f7a21307b7/jcm-10-00693-g001.jpg

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