Yalınkaya Ahmet, Oğlak Süleyman Cemil, Gündüz Reyhan, Yılmaz Emine Zeynep, Bolluk Gökhan, Yayla Murat
Department of Obstetrics and Gynecology, Dicle University Faculty of Medicine, Diyarbakır, Türkiye.
Clinic of Obstetrics and Gynecology, University of Health Sciences Türkiye, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye.
J Turk Ger Gynecol Assoc. 2025 Mar 12;26(1):26-33. doi: 10.4274/jtgga.galenos.2024.2024-9-9.
The aim of this study was to evaluate the effectiveness of emergency cervical cerclage (EmC) in twin pregnancies with a fully dilated cervix and amniotic membrane prolapse.
This retrospective study examined records from December 2015 to December 2022 and included 20 twin pregnancies. The patients were divided into two groups, the EmC group (EmC group) and the no EmC (control) group, and pregnancy outcomes were compared.
EmC was performed after amnioreduction in 11 twin pregnancies. Nine patients who refused EmC were followed up with expectant management. The mean gestational age at first examination was similar between the EmC (21.36±1.62 weeks) and control group (21.00±3.16 weeks, p=0.372). The median (range) volume of removed amniotic fluid was 151.82 (120-420) mL. Cases in the EmC group gained a significantly longer delay until delivery (47.72±28.14 days) compared to controls (2.33±0.5 days, p<0.001). All of the women in the control group gave birth within three days following admission to hospital. The mean gestational age at birth was significantly higher in the EmC group (28.18±4.53 weeks) than in the control group (21.57±3.53 weeks, p<0.001). Thirteen (59.09%) infants survived in the EmC group while only two infants (22.22%) of one patient survived in the control group (p<0.001).
EmC increases the survival rate of infants by prolonging the gestational age at delivery in twin pregnancies. Clinicians and patients should be encouraged regarding the use of EmC in twin pregnancies with a fully dilated cervix and prolapsed amniotic membranes.
本研究旨在评估紧急宫颈环扎术（EmC）在宫颈完全扩张且胎膜脱垂的双胎妊娠中的有效性。
这项回顾性研究检查了2015年12月至2022年12月期间的记录，纳入了20例双胎妊娠。将患者分为两组，即紧急宫颈环扎术组（EmC组）和未行紧急宫颈环扎术组（对照组），并比较妊娠结局。
11例双胎妊娠在羊水减量后进行了紧急宫颈环扎术。9例拒绝紧急宫颈环扎术的患者接受了期待治疗随访。紧急宫颈环扎术组首次检查时的平均孕周（21.36±1.62周）与对照组（21.00±3.16周，p = 0.372）相似。抽取的羊水的中位数（范围）体积为151.82（120 - 420）mL。与对照组（2.33±0.5天，p < 0.001）相比，紧急宫颈环扎术组患者直至分娩的延迟时间显著更长（47.72±28.14天）。对照组所有女性在入院后三天内分娩。紧急宫颈环扎术组出生时的平均孕周（28.18±4.53周）显著高于对照组（21.57±3.53周，p < 0.001）。紧急宫颈环扎术组13例（59.09%）婴儿存活，而对照组仅1例患者的2例婴儿（22.22%）存活（p < 0.001）。
紧急宫颈环扎术通过延长双胎妊娠的分娩孕周来提高婴儿存活率。对于宫颈完全扩张且胎膜脱垂的双胎妊娠，应鼓励临床医生和患者使用紧急宫颈环扎术。
