受孕后宫颈环扎术。

Postconceptional cervical cerclage.

作者信息

Ayhan A, Mercan R, Tuncer Z S, Tuncer R, Kişnişçi H A

机构信息

Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.

出版信息

Int J Gynaecol Obstet. 1993 Sep;42(3):243-6. doi: 10.1016/0020-7292(93)90218-l.

DOI:10.1016/0020-7292(93)90218-l

PMID:7901079

Abstract

OBJECTIVE

To determine the outcome and morbidity of pregnancies following cervical cerclage.

METHOD

Records were reviewed for 326 patients with 374 singleton pregnancies between 1980 and 1990.

RESULT

McDonald and Shirodkar procedures were carried out in 323 and 51 pregnancies, respectively. The procedure was classified as elective if based on past history (n = 330). In 44 pregnancies, cervical dilatation prompted operation. The overall fetal survival rate has increased from 17.7% to 79.1% after cervical cerclage. While the presence of cervical dilatation at suture placement had a prognostic value, the surgical technique, gestational age at suture placement and progestin therapy had no significant effect on survival. Premature rupture of membranes and chorioamnionitis were found to be the leading causes of morbidity.

CONCLUSION

Cervical cerclage seems to the treatment of choice in patients with cervical incompetence. Only the presence of cervical dilatation at operation was found to have a prognostic value among the factors analyzed.

摘要

目的

确定宫颈环扎术后妊娠的结局及发病率。

方法

回顾了1980年至1990年间326例患者的374次单胎妊娠记录。

结果

分别对323例和51例妊娠实施了麦克唐纳法和希罗德卡尔法。若基于既往史进行手术，则该手术分类为择期手术（n = 330）。44例妊娠因宫颈扩张而促使手术。宫颈环扎术后总体胎儿存活率从17.7%提高到了79.1%。虽然缝合时宫颈扩张的存在具有预后价值，但手术技术、缝合时的孕周及孕激素治疗对存活率无显著影响。胎膜早破和绒毛膜羊膜炎是发病的主要原因。