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宫颈机能不全行宫颈环扎术的双胎妊娠的妊娠结局。

Pregnancy outcomes of twin pregnancies with cervical insufficiency undergoing cervical cerclage.

机构信息

Department of Obstetrics, Xiangya Hospital Central South University, 87 Xiangya Road, Changsha, 410008, China.

School of Public Health, Capital Medical University, Beijing, China.

出版信息

Sci Rep. 2024 Nov 9;14(1):27414. doi: 10.1038/s41598-024-78662-2.

Abstract

Cervical cerclage is an established procedure for treating cervical insufficiency; however, its efficacy in twin pregnancies remains uncertain. This study aimed to evaluate the effectiveness of transvaginal cervical cerclage in twin pregnancies complicated by cervical insufficiency. Data were retrospectively collected from 155 women with twin pregnancies diagnosed with cervical insufficiency. Participants were divided into two groups: the cerclage group (n = 131) and the non-cerclage group (n = 24). The cerclage group was further subdivided into emergency cerclage and ultrasound-indicated cerclage subgroups for detailed analysis. The duration of gestation was found to be longer in the cerclage group compared to the non-cerclage group. Procedures performed included both emergency and ultrasound-indicated cerclage. No significant difference in gestational outcomes was observed between the ultrasound-indicated cerclage subgroup and the non-cerclage group, regardless of cervical length (< 15 mm, < 25 mm, or 15-25 mm). In contrast, a significant improvement in gestational outcomes was noted in the emergency cerclage subgroup compared to the non-cerclage group, irrespective of cervical dilation (> 1 cm or ≤ 1 cm). Overall, cervical cerclage appears to improve pregnancy outcomes in twin pregnancies under specific conditions. While ultrasonographically indicated cerclage did not significantly enhance pregnancy outcomes, emergency cerclage may be effective in improving perinatal prognosis.

摘要

宫颈环扎术是治疗宫颈机能不全的一种既定方法;然而,其在双胎妊娠中的疗效仍不确定。本研究旨在评估经阴道宫颈环扎术治疗宫颈机能不全的双胎妊娠的有效性。从 155 例诊断为宫颈机能不全的双胎妊娠妇女中回顾性收集数据。参与者分为两组:环扎组(n=131)和非环扎组(n=24)。环扎组进一步分为紧急环扎和超声指示环扎亚组进行详细分析。与非环扎组相比,环扎组的妊娠时间更长。进行的操作包括紧急环扎和超声指示环扎。无论宫颈长度(<15mm、<25mm 或 15-25mm)如何,超声指示环扎亚组与非环扎组的妊娠结局均无显著差异。相比之下,无论宫颈扩张程度(>1cm 或≤1cm)如何,紧急环扎亚组的妊娠结局均显著优于非环扎组。总体而言,宫颈环扎术似乎在特定条件下可以改善双胎妊娠的妊娠结局。虽然超声指示性环扎术并未显著提高妊娠结局,但紧急环扎术可能对改善围产期预后有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c31c/11550799/cb322a14a2ef/41598_2024_78662_Fig1_HTML.jpg

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