He Deying, Zhao Dan
Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing 401120, China.
Emerg Med Int. 2022 Jun 30;2022:8340009. doi: 10.1155/2022/8340009. eCollection 2022.
To analyze the effect of the choice of timing of cervical cerclage treatment on pregnancy outcome in pregnant women with cervical insufficiency (CI).
The case data of 160 pregnant women admitted to our hospital for cervical cerclage due to CI from January 2020 to September 2021 were sampled. They were divided into the early group (14∼18 weeks of pregnancy, = 86), the middle group (19∼27 weeks of pregnancy, = 74) according to the different gestational periods of surgical treatment, and into the elective group (elective operation, = 71) and the emergency group (emergency operation, = 89) according to the different timings of surgical treatment. To compare the pregnancy outcomes of the four groups and the effects of different treatment timings on pregnant women and newborns.
After the operation, the intrauterine infection rate in the early group was lower (8.14% (7/86)) than that (71.62% (53/74)) in the middle group, and the intrauterine infection rate (18.31% (13/71)) in the elective group was lower (61.80% (55/89)) than that in the emergency group ( < 0.05). After the operation, the late abortion rate in the early group was 8.14% (7/86) lower than 63.51% (47/74) in the middle group, and the late abortion rate in the elective group was 15.49% (11/71) lower than 61.80% (55/89) in the emergency group ( < 0.05). After the operation, the full-term birth rate (82.56% (71/86)) in the early group was higher (21.62% (16/74)) than that in the middle group, and the full-term birth rate (73.24% (52/71)) of the elective group was higher (24.72% (22/89)) than that in the emergency group ( < 0.05). After the operation, there was no significant difference in the preterm birth rate between the early group and the middle group (8.14% 14.86%), and between the elective group and the emergency group (11.27% 12.36%) ( > 0.05). There was no significant difference in neonatal Apgar scores between the early group and the middle group (7.30 ± 0.98 7.14 ± 0.91) scores, and between the selective group and the emergency group (7.15 ± 0.82 7.07 ± 1.07) scores ( > 0.05). There was no significant difference in gestational week extension time between the early group and the middle group (6.52 ± 1.77 6.99 ± 1.69) days and between the elective group and the emergency group (6.44 ± 1.37 6.82 ± 1.70) days ( > 0.05). The length of hospital stay was (7.28 ± 1.39 10.89 ± 2.65) days in the early group and the middle group, with the early group being shorter than the middle group ( < 0.05), and the length of hospital stay was (8.72 ± 1.23 9.30 ± 1.39) days in the elective group and the emergency group, with the elective group being shorter than the emergency group ( < 0.05).
The therapeutic effect and pregnancy outcome of cervical cerclage are affected by the timing of treatment. Among them, the effect of elective operation at 14∼18 weeks of pregnancy is more ideal, which is worthy of clinical promotion.
分析宫颈环扎术治疗时机的选择对宫颈机能不全（CI）孕妇妊娠结局的影响。
选取2020年1月至2021年9月因CI在我院接受宫颈环扎术的160例孕妇的病例资料。根据手术治疗的不同孕周分为早期组（妊娠14～18周，n = 86）、中期组（妊娠19～27周，n = 74），根据手术治疗的不同时机分为择期组（择期手术，n = 71）和急诊组（急诊手术，n = 89）。比较四组的妊娠结局以及不同治疗时机对孕妇和新生儿的影响。
术后，早期组的宫内感染率（8.14%（7/86））低于中期组（71.62%（53/74）），择期组的宫内感染率（18.31%（13/71））低于急诊组（61.80%（55/89））（P < 0.05）。术后，早期组的晚期流产率为8.14%（7/86），低于中期组的63.51%（47/74），择期组的晚期流产率为15.49%（11/71），低于急诊组的61.80%（55/89）（P < 0.05）。术后，早期组的足月分娩率（82.56%（71/86））高于中期组（21.62%（16/74）），择期组的足月分娩率（73.24%（52/71））高于急诊组（24.72%（22/89））（P < 0.05）。术后，早期组与中期组的早产率（8.14%对14.86%）、择期组与急诊组的早产率（11.27%对12.36%）比较，差异均无统计学意义（P > 0.05）。早期组与中期组的新生儿Apgar评分（7.30±0.98对7.14±0.91）、选择性组与急诊组的新生儿Apgar评分（7.15±0.82对7.07±1.07）比较，差异均无统计学意义（P > 0.05）。早期组与中期组的孕周延长时间（6.52±1.77对6.99±1.69）天、择期组与急诊组的孕周延长时间（6.44±1.37对6.82±1.70）天比较，差异均无统计学意义（P > 0.05）。早期组和中期组的住院时间为（7.28±1.39对10.89±2.65）天，早期组短于中期组（P < 0.05），择期组和急诊组的住院时间为（8.72±1.23对9.30±1.39）天，择期组短于急诊组（P < 0.05）。
宫颈环扎术的治疗效果和妊娠结局受治疗时机的影响。其中，妊娠14～18周择期手术的效果较为理想，值得临床推广。
