Craig S, Fliegner J R
Department of Obstetrics and Gynaecology, University of Melbourne.
Aust N Z J Obstet Gynaecol. 1997 Nov;37(4):407-11. doi: 10.1111/j.1479-828x.1997.tb02448.x.
Cervical incompetence is a condition traditionally treated by cervical cerclage which in most cases is inserted via the transvaginal route. However the insertion of a transabdominal cervicoisthmic suture is indicated in those patients with recurrent mid-trimester losses due to an incompetent cervix where it is not technically possible to insert a transvaginal suture. Between 1987 and 1996, 12 women at the Royal Women's Hospital, Melbourne were treated with transabdominal cervicoisthmic cerclage (TCC). Eight patients had cerclage in the nonpregnant state, and 4 were pregnant at the time. The completed pregnancies thus far have resulted in 10 surviving infants, a successful pregnancy rate of 69.2%. This compares favourably with a corrected preTCC successful pregnancy rate of only 13%. There were minimal intraoperative complications in our series. Bleeding, chorioamnionitis and premature rupture of the membranes have been reported elsewhere and occurred in 2 of our patients. Our results and a review of the literature confirms that TCC has an important role in carefully-selected patients.
宫颈机能不全是一种传统上通过宫颈环扎术治疗的病症，在大多数情况下是经阴道途径进行环扎。然而，对于因宫颈机能不全而在孕中期反复流产且技术上无法经阴道进行缝合的患者，则需行经腹宫颈峡部缝合术。1987年至1996年间，墨尔本皇家妇女医院有12名女性接受了经腹宫颈峡部环扎术（TCC）。8例患者在非孕状态下进行了环扎，4例在当时已怀孕。截至目前，已完成的妊娠共娩出10名存活婴儿，成功妊娠率为69.2%。这与TCC术前校正后的仅13%的成功妊娠率相比要好得多。我们系列研究中的术中并发症极少。其他地方曾报道过出血、绒毛膜羊膜炎和胎膜早破，我们的2例患者也出现了这些情况。我们的研究结果以及对文献的回顾证实，TCC在精心挑选的患者中具有重要作用。
