Department of Obstetrics and Gynecology, University of Hallym College of Medicine, Hallym Sacred Heart Hospital, Anyang, Republic of Korea.
Department of Obstetrics and Gynecology, University of Hallym College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
Biomed Res Int. 2022 Nov 30;2022:9450141. doi: 10.1155/2022/9450141. eCollection 2022.
To report the pregnancy and neonatal outcomes in patients with twin pregnancies who underwent ultrasound-indicated cerclage (UIC) and to compare them to patients with singleton pregnancies undergoing the same procedures.
Patients who underwent UIC between January 2010 and December 2020 at Kangnam Sacred Heart Hospital were reviewed. We compared characteristics, pregnancy, and neonatal outcomes between patients with singleton and twin pregnancies.
A total of 94 women (56 singleton and 38 twin pregnancies) underwent UIC were included. The mean gestational age (GA) at cerclage and preoperative cervical length (CL) were not significantly different. Twin pregnancies were more likely to deliver at earlier median gestations than singletons (singleton, 36 + 1 weeks vs twin, 32 + 6 weeks, and = 0.004). The frequency of preterm delivery <34 weeks in twin group was higher than in singleton group (15 (26.8%) vs 20 (52.6%) and =0.016). However, the frequency of preterm delivery <32, <28, and <24 weeks was not significantly different between two groups. Although neonatal weights in singleton pregnancies were heavier than twin pregnancies, neonatal mortality and morbidities were not significantly different between two groups. Among various factors contributing to preterm birth, preoperative CL ≤ 15 mm was independently associated with a higher risk of preterm delivery before 34 weeks. Furthermore, pregnancy and neonatal outcomes of twin pregnancies with cervical length ≤ 15 mm are comparable with those of singleton pregnancies (GA at delivery, singleton, 35 + 1 weeks vs twin, 32 + 5 weeks, and = 0.24; neonatal mortality, singleton, 3.4% vs twin, 4.8%, and = 0.64).
The pregnancy and neonatal outcomes of UIC in twin pregnancies were comparable to those in singleton pregnancies, especially when CL is ≤15 mm. UIC might be considered a safe procedure for twin pregnancies.
报告经超声检查指示行宫颈环扎术（UIC）的双胎妊娠患者的妊娠和新生儿结局，并将其与行相同手术的单胎妊娠患者进行比较。
回顾 2010 年 1 月至 2020 年 12 月在江南圣心医院接受 UIC 的患者。我们比较了单胎和双胎妊娠患者的特征、妊娠和新生儿结局。
共纳入 94 名患者（56 例单胎和 38 例双胎妊娠）接受 UIC。环扎术时的平均孕龄（GA）和术前宫颈长度（CL）无显著差异。双胎妊娠的中位分娩孕周早于单胎妊娠（单胎妊娠为 36+1 周，双胎妊娠为 32+6 周， = 0.004）。双胎妊娠早产<34 周的发生率高于单胎妊娠（15（26.8%）vs 20（52.6%）， =0.016）。然而，两组之间早产<32 周、<28 周和<24 周的发生率无显著差异。虽然单胎妊娠新生儿体重较重，但两组新生儿死亡率和并发症发生率无显著差异。在导致早产的各种因素中，术前 CL≤15 mm 与早产<34 周的风险增加独立相关。此外，宫颈长度≤15 mm 的双胎妊娠的妊娠和新生儿结局与单胎妊娠相当（分娩时 GA，单胎妊娠为 35+1 周，双胎妊娠为 32+5 周， = 0.24；新生儿死亡率，单胎妊娠为 3.4%，双胎妊娠为 4.8%， = 0.64）。
UIC 治疗双胎妊娠的妊娠和新生儿结局与单胎妊娠相当，尤其是当 CL≤15 mm 时。UIC 可能被认为是双胎妊娠的一种安全手术。
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