Litschgi M
Z Geburtshilfe Perinatol. 1979 Apr;183(2):156-62.
Cerclage was performed by us during the past 5 1/2 years in 71 women (0.68% of all births). In 23 women, cerclage was performed prophylactically and in 48 women as therapy of early maturing of the cervix. Cerclage was applied, mainly according to McDonald, between the 13th and 33rd weeks of pregnancy, maximum incidence of surgery occurring between the 17th and 27th week (63%). Cervical insufficiency is only temporarily removed by cerclage. After the suture has been removed, cervical dilatation should be variable. If this is not the case, the diagnosis of "cervical insufficiency" must be considered doubtful. This criterion was fulfilled in 83% of the therapeutic cases of cerclage compared with 43% in the prophylactic cases. Within 24 hours after removal of this suture, 39 patients (59%) had given birth. The prophylactically indicated cerclages often did not meet the criterion cervical dilatation uteri after removal of suture and rapid birth", whereas the majority of the therapeutic cerclages complied with the criterion. Our results are compared with those published in the literature. Despite the trend noticeable in literature towards a more liberal indication of cerclage, we will continue to perform this operation with discretion.
在过去的5年半时间里，我们对71名女性实施了宫颈环扎术（占所有分娩数的0.68%）。其中23名女性接受了预防性宫颈环扎术，48名女性接受了宫颈过早成熟的治疗性宫颈环扎术。宫颈环扎术主要按照麦克唐纳法实施，手术时间在妊娠第13周至33周之间，手术发生率最高的时间段为第17周至27周（63%）。宫颈环扎术只能暂时缓解宫颈机能不全的问题。拆除缝线后，宫颈扩张情况应有所不同。如果情况并非如此，“宫颈机能不全”的诊断就值得怀疑。在治疗性宫颈环扎术病例中，83%符合这一标准，而预防性宫颈环扎术病例中这一比例为43%。拆除缝线后的24小时内，39名患者（59%）分娩。预防性宫颈环扎术在拆除缝线后往往不符合“子宫颈扩张及快速分娩”这一标准，而大多数治疗性宫颈环扎术符合这一标准。我们将我们的结果与文献中发表的结果进行了比较。尽管文献中有扩大宫颈环扎术适应证的趋势，但我们仍将谨慎地继续开展这项手术。
