双胎与单胎妊娠中超声引导与体格检查引导下的宫颈环扎术
Ultrasound-indicated and physical examination-indicated cervical cerclage in twin versus singleton gestations.
作者信息
Amitai Komem Daphna, Meyer Raanan, Yagel Itai, Shai Daniel, Mashiach Roy, Hendler Israel, Mazaki-Tovi Shali, Yinon Yoav
机构信息
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
J Obstet Gynaecol Res. 2025 Mar;51(3):e16263. doi: 10.1111/jog.16263.
AIM
To compare the safety and efficacy of ultrasound- and physical examination-indicated cervical cerclage in twin versus singleton gestations.
METHODS
A retrospective cohort study of all ultrasound-indicated (cervical length ≤ 25 mm) and physical examination-indicated cerclage cases performed over a 9-year period. The primary outcome was the time interval from cerclage placement to delivery.
RESULTS
The study cohort included 94 singleton and 16 twin pregnancies. The time interval from cerclage placement to delivery was comparable in singleton and twin gestations (14.77 vs. 12.07 weeks, p = 0.11), as were the rates of preterm births before 28 and 32 weeks. The rate of alive newborns >24 weeks was lower in the twin group (71.9% vs. 88.3%, p = 0.028). Regression analysis identified that cervical dilation, but not twin gestation, was the only factor independently associated with an increased risk for birth before 32 weeks.
CONCLUSION
Ultrasound-indicated and physical examination-indicated cerclage had comparable efficacy in prolonging pregnancy in twin and singleton gestations, though live birth rates were lower in twins.
目的
比较超声引导与体格检查引导下宫颈环扎术在双胎妊娠与单胎妊娠中的安全性和有效性。
方法
一项回顾性队列研究，纳入9年期间所有超声引导（宫颈长度≤25mm）和体格检查引导下的宫颈环扎病例。主要结局是从宫颈环扎到分娩的时间间隔。
结果
研究队列包括94例单胎妊娠和16例双胎妊娠。单胎妊娠和双胎妊娠从宫颈环扎到分娩的时间间隔相当（14.77周对12.07周，p = 0.11），28周和32周前的早产率也相当。双胎组24周以上存活新生儿的比例较低（71.9%对88.3%，p = 0.028）。回归分析确定，宫颈扩张而非双胎妊娠是与32周前分娩风险增加独立相关的唯一因素。
结论
超声引导和体格检查引导下的宫颈环扎术在延长双胎妊娠和单胎妊娠的孕周方面疗效相当，尽管双胎的活产率较低。
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