Oka K, Kataoka A, Yokota D, Motomura S, Kawano K
Department of Obstetrics and Gynecology, St. Mary Hospital, Kurume.
Nihon Sanka Fujinka Gakkai Zasshi. 1993 Jul;45(7):621-8.
During the period January 1, 1989 through December 31, 1991, one hundred thirty-six pregnant women with an effaced and widely dilated cervix or with bulging membranes were treated by emergent cervical cerclage. Suturing was carried out in 16 women before 20 weeks gestation, in 86 women between 20 and 28 weeks and in 34 women after 28 weeks. 16 patients in group A were those whose pregnancy was terminated with 3 days after operation and their tocolysis index was significantly higher than that of 69 patients in group D, whose pregnancy was prolonged move than two weeks. Clinical chorioamnionitis (WBC > 15,000/mm3 and CRP > 2mg/dl) was occurring in 43.7% of patients in group A, compared with 8.7% in group D at the time of operation. Vaginal delivery was accomplished in 38 patients at between 24 and 36 weeks gestation in our hospital, while 41 cesarean sections were performed. On the basis of these results, we conclude that the emergency cerclage operation may improve the outcome of pregnancy but we have to pay special attention to premature rupture of membranes and chorioamnionitis.
在1989年1月1日至1991年12月31日期间，对136名宫颈消失且扩张明显或胎膜膨出的孕妇进行了紧急宫颈环扎术治疗。在妊娠20周前对16名妇女进行了缝合，20至28周之间对86名妇女进行了缝合，28周后对34名妇女进行了缝合。A组的16名患者在术后3天终止妊娠，其宫缩抑制指数显著高于D组的69名患者，D组患者的妊娠延长超过两周。手术时，A组43.7%的患者发生临床绒毛膜羊膜炎（白细胞>15,000/mm³且C反应蛋白>2mg/dl），而D组为8.7%。我院38名患者在妊娠24至36周时成功进行了阴道分娩，同时进行了41次剖宫产。基于这些结果，我们得出结论，紧急环扎术可能会改善妊娠结局，但我们必须特别注意胎膜早破和绒毛膜羊膜炎。
