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与宫颈手术闭合相关的妊娠病史及病程(作者译)

[Anamnesis and course of gestation associated with surgical closure of the cervix (author's transl)].

作者信息

Wagner G, Salzer H, Reinold E

出版信息

Z Geburtshilfe Perinatol. 1978 Feb;182(1):68-78.

PMID:645167
Abstract

During a time interval of 2 years in 7% of the gravidae at the First Department of Obstetrics and Gynecology, University of Vienna, a surgical closure of the cervix was performed. The anamnestic and clinical data of these 221 gravidae were compared with a compatible collective of another 221 gravidae without a surgical closure (control-group). In the closuregroup 27,6% were primigravidae. The mean age of the gravidae was 28,8 years and statistically higher than in the control group (25,7 years). Also the mean age of the multigravidae at the time of their first gestation was statistically higher (23,9 years and 22 years respectively). The anamnestic amount of abortion and perinatal mortality was 63,5% and 24,3% respectively, significantly higher was also the anamnestic rate of curettages. In most of the cases surgical closure was indicated by palpation of the cervix, 3 degrees of insufficiency of the cervix were differentiated. There was a great importance of a postsurgical treatment with tocolytic drugs (83% and 10% respectively), but there was also a different mode of application. During the course of gestation a lower frequency of EPH-gestosis (64 gravidae and 90 gravidae respectively) but a higher incidence of diabetes (11 gravidae and 5 gravidae respectively) and a higher incidence of urinary infection (20 gravidae and 7 gravidae respectively) were observed. In patients with a cervical closure a higher rate of rupture of membranes and premature labor were present. Surgical technique and time of closure had no significant influence on the outcome of pregnancy. The rate of success was 86.4%.

摘要

在维也纳大学第一妇产科,7%的孕妇在两年时间间隔内接受了宫颈手术闭合术。将这221名孕妇的既往史和临床数据与另外221名未接受手术闭合术的匹配孕妇群体(对照组)进行了比较。在闭合组中,27.6%为初产妇。孕妇的平均年龄为28.8岁,在统计学上高于对照组(25.7岁)。多产妇首次妊娠时的平均年龄在统计学上也更高(分别为23.9岁和22岁)。既往流产和围产期死亡率分别为63.5%和24.3%,刮宫率在既往史中也显著更高。在大多数病例中,通过触诊宫颈来指示手术闭合,区分了3度宫颈机能不全。使用宫缩抑制剂进行术后治疗非常重要(分别为83%和10%),但应用方式也有所不同。在妊娠过程中,观察到妊娠高血压综合征的发生率较低(分别为64名孕妇和90名孕妇),但糖尿病的发生率较高(分别为11名孕妇和5名孕妇),尿路感染的发生率也较高(分别为20名孕妇和7名孕妇)。接受宫颈闭合术的患者胎膜破裂和早产的发生率较高。手术技术和闭合时间对妊娠结局没有显著影响。成功率为86.4%。

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