Mahran M
Obstet Gynecol. 1978 Oct;52(4):502-6.
A modified surgical technique for carrying out cervical cerclage by the transabdominal route during pregnancy is presented. It is designed for the patient whose cervix is so short or damaged that the transvaginal procedure is not feasible. Basically, the method consists of a standard laparotomy at which a nylon tape is placed around the uterine isthmus medial to the uterine vessels and fixed to the anterior isthmus, Mackenrodt's ligaments, and to the insertions of the uterosacral ligaments. Results in 10 cases are reported. There were no operative or postoperative complications. One case was terminated by early spontaneous abortion and 2 by hysterotomy at 26 and 30 weeks, respectively, because of placenta previa. Seven cases were terminated by cesarean section at or near term, with delivery of 7 infants who survived. The 7 mothers had had a total of 50 prior pregnancies with only 5 living children; 4 of them had ahd 25 prior pregnancies with no living children. Various aspects of the procedure are discussed.
本文介绍了一种在孕期经腹途径实施宫颈环扎术的改良手术技术。该技术适用于宫颈过短或受损而无法行经阴道手术的患者。基本上，该方法包括标准剖腹术，在此过程中将尼龙带置于子宫血管内侧的子宫峡部周围，并固定于峡部前部、 Mackenrodt韧带以及子宫骶韧带附着处。报告了10例手术结果。无手术或术后并发症。1例因早期自然流产而终止妊娠，2例分别因前置胎盘于孕26周和30周行子宫切开术终止妊娠。7例在足月或接近足月时行剖宫产术终止妊娠，娩出7名存活婴儿。这7名母亲既往共有50次妊娠，仅5名子女存活；其中4名母亲既往有25次妊娠，无存活子女。文中讨论了该手术的各个方面。
