Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Teaching Hospital, Nnewi, Anambra State; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka; Department of Obstetrics and Gynaecology, Life International Hospital, Awka and Life Specialist Hospital, Nnewi, Anambra State, Nigeria.
Human Reproduction Unit, Institute of Maternal and Child Health, University of Nigeria, Enugu Campus; Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria.
Niger J Clin Pract. 2023 May;26(5):630-635. doi: 10.4103/njcp.njcp_830_22.
Cervical cerclage is the procedure of choice for preventing preterm birth due to cervical insufficiency. Despite the simplicity of the McDonald's method of cerclage application, it is still technically difficult to take four bites around the cervix before knotting. There is a need to develop a simpler method of cervical cerclage application with similar or improved pregnancy outcomes.
This is to compare the ease/duration of application and pregnancy outcomes of the new triangular three-bite cervical cerclage technique and McDonald's technique in women with cervical insufficiency.
This is a pilot study with 20 participants that met the inclusion criteria. They were randomly grouped into triangular three-bite method (n = 10) and McDonald's method (n = 10). The pregnancy outcomes were compared between the groups with the Chi-square test and student's t-test. A P value of <.05 was set as level of significance.
The sociodemographic characteristics of the two groups were similar. There was no statistically significant difference between the two groups regarding the pregnancy outcome (spontaneous miscarriage P = 1.00, preterm delivery P = 0.61, and neonatal birthweight P = 0.96). However, the duration of cerclage application (5.98 ± 1.79 minutes vs. 14.25 ± 7.5 minutes; P <.002) and estimated blood loss (29 ± 9.94 mls vs. 48.5 ± 25.82 mls; P = .04) were significantly lower in the triangular three-bite arm than in the McDonald's arm.
The new triangular three-bite technique has similar pregnancy outcomes with the conventional McDonald's technique and has shown a lower duration of procedure and blood loss. Since this is a pilot study, a well-structured randomized control trial to compare the two methods is recommended.
宫颈环扎术是预防因宫颈功能不全导致早产的首选方法。尽管 McDonald 法宫颈环扎术的应用方法简单，但在宫颈周围进行四针打结前，技术上仍具有一定难度。因此，需要开发一种更简单的宫颈环扎术应用方法，以获得类似或更好的妊娠结局。
比较新型三角三针宫颈环扎术与 McDonald 法在宫颈机能不全患者中应用的简便性/操作时间和妊娠结局。
这是一项纳入符合标准的 20 例患者的前瞻性研究，将其随机分为三角三针法组（n = 10）和 McDonald 法组（n = 10）。采用卡方检验和学生 t 检验比较两组的妊娠结局。P 值<.05 为差异有统计学意义。
两组患者的社会人口学特征相似。两组间妊娠结局（自然流产 P = 1.00、早产 P = 0.61、新生儿出生体重 P = 0.96）无统计学差异。然而，三角三针法组的环扎操作时间（5.98 ± 1.79 分钟 vs. 14.25 ± 7.5 分钟；P<.002）和估计出血量（29 ± 9.94 mls vs. 48.5 ± 25.82 mls；P =.04）均显著低于 McDonald 法组。
新型三角三针法与传统 McDonald 法具有相似的妊娠结局，且操作时间和出血量更少。由于这是一项初步研究，建议开展一项设计良好的随机对照试验来比较两种方法。
