经腹宫颈环扎术在妊娠期的应用：25 年来单中心回顾性系列研究。
Transabdominal cerclage during pregnancy: A retrospective single operator series over a quarter century.
机构信息
Department of Obstetrics and Gynaecology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
出版信息
Int J Gynaecol Obstet. 2023 Mar;160(3):926-932. doi: 10.1002/ijgo.14426. Epub 2022 Sep 19.
OBJECTIVE
To describe the pregnancy outcomes and complications observed in a series of cases of transabdominal cerclage (TAC), which is reserved for highly selected women with recurrent mid-trimester pregnancy loss, due to cervical insufficiency.
METHODS
A retrospective audit covering 25 years (January 1, 1997 to December 31, 2021) was performed at the Obstetric Special Care division, Tygerberg Academic Hospital in Cape Town, South Africa. All 118 pregnancies from 94 procedures, operated and managed by the principal author were included for descriptive analysis.
RESULTS
Eighty-four (91.3%) of the 92 first pregnancies after first insertion had successful outcomes. All second and third pregnancies (24/24; 100%) were successful. Eight pregnancies did not achieve viability, two women (2/8) did however achieve a successful pregnancy after a subsequent repeat TAC procedure. For the viable pregnancies (110/118), the median gestational age at delivery was 37 weeks (range 28-39 weeks). The median intraoperative blood loss during cerclage insertion was 100 ml (range 25-750 ml).
CONCLUSION
In experienced hands, TAC during pregnancy is a safe and effective operation, when other less invasive procedures have failed.
目的
描述一系列经腹环扎术（TAC）病例中观察到的妊娠结局和并发症。TAC 是为因宫颈机能不全而反复发生妊娠中期流产的高度选择女性保留的手术。
方法
在南非开普敦泰格伯格学术医院的产科特殊护理科进行了一项回顾性审核，时间跨度为 25 年（1997 年 1 月 1 日至 2021 年 12 月 31 日）。纳入了由主要作者进行手术和管理的 94 例手术中的 118 例妊娠进行描述性分析。
结果
92 例首次插入后的首次妊娠中，84 例（91.3%）结局成功。所有第二和第三例妊娠（24/24；100%）均成功。8 例妊娠未能存活，但其中 2 例（2/8）在随后重复 TAC 手术后成功妊娠。对于可存活的妊娠（110/118），分娩时的中位孕龄为 37 周（范围 28-39 周）。环扎插入术中的中位术中失血量为 100ml（范围 25-750ml）。
结论
在有经验的医生手中，当其他侵入性较小的手术失败时，TAC 在妊娠期间是一种安全有效的手术。
Zotero 插件