多胎妊娠流产、早产高危因素及预防对策

High risk factors and preventive strategies of Abortion or prematurity in multiple pregnancy Maternity

目的:分析多胎妊娠流产、早产的高危因素,探讨宫颈环扎术预防高危人群流产、早产的临床效果。方法:选择2011-01～2012-05收治的多胎妊娠患者97例,经阴道宫颈彩超测量宫颈长度≤2cm,宫颈内口宽度>1cm的47例作为高危组,其余50例为低危组,选择高危组47例中自愿行宫颈环扎术的26例作为高危环扎组,其余21例作为高危未环扎组。结果:高危环扎组流产1例(3.85%),高危未环扎组流产7例(33.3%),两者比较差异显著,高危环扎组早产9例(34.6%),高危未环扎组早产8例(38.1%),两者比较差异不明显。结论:利用经阴道宫颈彩超检查宫颈形态可筛查出多胎妊娠自然流产的高危人群,宫颈环扎术可显著降低多胎妊娠高危人群的流产率。

Objective：To analyze high risk factors and research clinical effect of cervical cerclage to prevent abortion or prematurity of high risk group who are multiple pregnancy. Methods：97 multiple pregnancy patients treated in our hospital from January 2011 to May 2012, were chosen. 47 cases whose cervix length measured by transvaginal cervical uhrasonography were not enough 2 centimeter and cervix endostoma width exceeded 1 centimeter were regarded as high risk group. The other 50 cases were regard as low - risk group. Among 47 patients high risk group, 26 cases who were voluntary to accept cervical cerclage were regard as highrisk cerclage group, the other 21patients were regard as highrisk none cerclage group. Results： 1 abortion in high - risk cerclage group （3.85%）, and 7 abortions in high 7 risk none cerclage group （33.3%）. There was significant difference. 9 prematurities in high - risk cerclage group （34. 6% ）, and 8 prematurities in high -risk none cerclage group （38. 1% ）. There was no significant difference. Conclusions： We can screen high risk group of spontaneous abortion of multiple pregnancy through check of cervix shape by transvaginal cervical uhrasonography. Abortion rate of high risk group of multiple pregnancy can be significantly reduced by cervical cerclage.