Kubinyi J, Pilishegyi J, Lacza T
Zentralbl Gynakol. 1976;98(17):1043-8.
In the course of the analysis of the results of 175 cerclage-operations carried out during the last 5 years, the authors intended to answer the question: whether the operation is reasonable on the basis of a prophylactic indication. As indication of this kind has been considered for example the following: when in the case-history of the patient one or more spontaneous abortions have occured after the third month of gravidity--with insufficient symptoms, when the mother's birth was a full-term confinement after cerclage-operation, finally, when the insufficiency of the cervical os had been diagnosed before getting pregnant. At symptoms of incipient abortion the aim of the medical treatment was therapeutic. The prophylactic operation was performed between the 16-18th week of the pregnancy, while the therapeutic one between the 20th and 30th week. In the first group 97,2 per cent was the rate of the viable children, while in the second one: 67,2 per cent. The well-foundedness of the prophylactic indication is proved by the fact that the number of full-term confinements has been quinetupled, compared with the pre-operation state. In our opinion in case of typical anamnesis the cerclage-operation is to be performed earlier than in the practice up till now, before opening the cervical os, and the infection of the amnion.
在对过去5年中进行的175例宫颈环扎术的结果进行分析的过程中,作者试图回答以下问题:基于预防性指征,该手术是否合理。例如,以下情况被视为这种指征:在患者病史中,妊娠第三个月后发生一次或多次自然流产且症状不充分;母亲在宫颈环扎术后足月分娩;最后,在怀孕前已诊断出宫颈机能不全。在出现早期流产症状时,医疗治疗的目的是治疗性的。预防性手术在妊娠第16 - 18周进行,而治疗性手术在第20至30周进行。第一组中活产婴儿的比例为97.2%,而第二组为67.2%。与术前状态相比,足月分娩的数量增加了四倍,这一事实证明了预防性指征的合理性。我们认为,在典型的既往史情况下,宫颈环扎术应比目前的实践更早进行,即在宫颈口开放和羊膜感染之前。