Gibb D M, Salaria D A
Women's Services Care Group, King's Healthcare, King's College Hospital, London, UK.
Br J Obstet Gynaecol. 1995 Oct;102(10):802-6. doi: 10.1111/j.1471-0528.1995.tb10846.x.
To evaluate the role of transabdominal cervicoisthmic cerclage (TCC) in the management of recurrent mid-trimester pregnancy miscarriage and preterm delivery.
An observational study of 50 women with history of recurrent second trimester miscarriage and preterm delivery in whom TCC was performed.
A tertiary referral centre for high risk obstetrics.
TCC was performed on 51 occasions in 50 women. One had TCC performed in two successive pregnancies. Prior to the procedure, they had experienced 36 first trimester miscarriages and 163 later pregnancy losses. These included 152 midtrimester miscarriages and 11 neonatal deaths after preterm delivery. There had been 4 survivors after preterm delivery. The total number of pregnancies after TCC was 61 with three women losing one pregnancy and subsequently having a successful pregnancy. Of these women 44 now have had a successful outcome. Six have not had a successful outcome. Eight women have had two successful consecutive pregnancies after TCC. The fetal survival was 85.2% post-procedure.
TCC is a procedure that may be used in a highly selected group of women with anatomical defects of the cervix and previous failed transvaginal cerclage resulting in recurrent second trimester pregnancy loss and preterm birth. Strict selection criteria were applied as TCC is an invasive procedure. Although TCC is not widely used our study suggests it may be the procedure to consider in women who have had recurrent second trimester pregnancy losses and preterm births associated with cervical damage.
评估经腹宫颈峡部环扎术（TCC）在处理孕中期复发性流产和早产中的作用。
对50例行TCC的有孕中期复发性流产和早产史的女性进行的观察性研究。
一家高危产科三级转诊中心。
50名女性共进行了51次TCC。其中1名女性在连续两次妊娠中均接受了TCC。在手术前，她们经历了36次孕早期流产和163次后期妊娠丢失。其中包括152次孕中期流产和11例早产新生儿死亡。有4例早产存活者。TCC后妊娠总数为61次，3名女性有1次妊娠失败，随后成功妊娠。这些女性中，44名目前结局成功。6名结局未成功。8名女性在TCC后有两次连续成功妊娠。术后胎儿存活率为85.2%。
TCC是一种可用于经过严格挑选的、有宫颈解剖缺陷且既往经阴道环扎失败导致孕中期复发性流产和早产的女性的手术。由于TCC是一种侵入性手术，因此应用了严格的选择标准。虽然TCC未被广泛应用，但我们的研究表明，对于有与宫颈损伤相关的孕中期复发性流产和早产的女性，它可能是一种可考虑的手术方式。
