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宫颈环扎术时机与术后结局的关联:一项回顾性研究。

Association between the timing of cervical cerclage placement and postoperative outcomes: A retrospective study.

作者信息

Zhao Lirong, Dai Xueli, Chen Xu, Yu Yingchun

机构信息

Department of Obstetrics, Zibo Maternal and Child Health Hospital, China.

Ultrasonic Department, Zibo Maternal and Child Health Hospital, China.

出版信息

J Int Med Res. 2025 Aug;53(8):3000605251367409. doi: 10.1177/03000605251367409. Epub 2025 Aug 20.

DOI:10.1177/03000605251367409
PMID:40836205
Abstract

PurposeTo explore the association between the timing of cervical cerclage placement and postoperative outcomes.MethodsWe retrospectively analyzed postoperative outcomes in pregnant women who underwent cervical cerclage at our hospital between January 2020 and December 2023. Participants were divided into nonterm and term birth groups.ResultsCompared with the term birth group, the nonterm birth group had significantly shorter cervical length (10.02 ± 8.17 vs. 23.40 ± 10.93 mm; p < 0.001), wider cervical orifice width (7.50 ± 10.71 vs. 1.12 ± 4.79 mm; p < 0.001), longer duration of postoperative hospitalization (29.53 ± 22.76 vs. 18.12 ± 21.26 days; p < 0.001), longer administration period of tocolytics (28.13 ± 22.26 vs. 16.15 ± 21.30 days; p < 0.001), lower neonatal birth age (33.07 ± 3.27 vs. 38.32 ± 0.95 weeks; p < 0.001), lower neonatal birth weight (2081.40 ± 641.36 vs. 3266.30 ± 352.76 g; p < 0.001), and lower Apgar score at 1 minute (10 (3-10) vs. 10 (3-10); p < 0.001). Cervical length showed higher sensitivity in determining the timing of cervical cerclage placement (area under the receiver operating characteristic curve: 0.830 vs. 0.669), with a cutoff value of 17 mm (sensitivity: 83.33%, specificity: 71.43%).ConclusionCervical cerclage may be beneficial in asymptomatic pregnancies where the cervical length is ≤17 mm or the cervix is undilated.

摘要

目的

探讨宫颈环扎术的实施时机与术后结局之间的关联。

方法

我们回顾性分析了2020年1月至2023年12月期间在我院接受宫颈环扎术的孕妇的术后结局。参与者被分为未足月分娩组和足月分娩组。

结果

与足月分娩组相比,未足月分娩组的宫颈长度显著更短(10.02±8.17 vs. 23.40±10.93毫米;p<0.001),宫颈口宽度更宽(7.50±10.71 vs. 1.12±4.79毫米;p<0.001),术后住院时间更长(29.53±22.76 vs. 18.12±21.26天;p<0.001),宫缩抑制剂使用时间更长(28.13±22.26 vs. 16.15±21.30天;p<0.001),新生儿出生孕周更低(33.07±3.27 vs. 38.32±0.95周;p<0.001),新生儿出生体重更低(2081.40±641.36 vs. 3266.30±352.76克;p<0.001),1分钟时的阿氏评分更低(10(3 - 10)vs. 10(3 - 10);p<0.001)。宫颈长度在确定宫颈环扎术的实施时机方面具有更高的敏感性(受试者操作特征曲线下面积:0.830 vs. 0.669),临界值为17毫米(敏感性:83.33%,特异性:71.43%)。

结论

对于宫颈长度≤17毫米或宫颈未扩张的无症状孕妇,宫颈环扎术可能有益。

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本文引用的文献

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A Novel Technique of Laparoscopic Transabdominal Cerclage after a Mersilene Tape Erosion in a Prior Laparoscopic Radical Trachelectomy and Transvaginal Cerclage Patient.在一名曾接受腹腔镜根治性宫颈切除术及经阴道宫颈环扎术且发生了Mersilene带侵蚀的患者中,一种新型腹腔镜经腹宫颈环扎技术。
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Prediction of outcomes for rescue cerclage in cervical insufficiency: A multicenter retrospective study.宫颈机能不全患者紧急宫颈环扎术结局的预测:一项多中心回顾性研究。
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Maternal Risk Factors Associated with Preterm Birth: A Case Control Study.
母亲相关危险因素与早产的相关性:病例对照研究。
J Nepal Health Res Counc. 2024 Mar 22;21(3):505-513. doi: 10.33314/jnhrc.v21i3.4933.
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Factors Associated with Spontaneous Preterm Birth after Ultrasound-Indicated Cerclage.超声引导下宫颈环扎术后自发性早产的相关因素
J Pers Med. 2023 Dec 1;13(12):1678. doi: 10.3390/jpm13121678.
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Validating staging criteria for sonographic and physical examination for cervical changes at <24 weeks' gestation to predict preterm birth.验证 24 周前的超声和体格检查用于预测早产的宫颈变化的分期标准。
Am J Obstet Gynecol MFM. 2024 May;6(5S):101211. doi: 10.1016/j.ajogmf.2023.101211. Epub 2023 Nov 4.
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Protruding vs. visible prolapsed fetal membranes adversely affects the outcome of cervical insufficiency.突出的与可见的胎膜脱垂会对宫颈机能不全的结局产生不良影响。
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Cervical cerclage for prevention of preterm birth and adverse perinatal outcome in twin pregnancies with short cervical length or cervical dilatation: A systematic review and meta-analysis.宫颈环扎术预防宫颈长度短或宫颈扩张的双胎妊娠早产及不良围产结局:系统评价和荟萃分析。
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