B超监测宫颈长度及治疗性宫颈环扎术在双胎妊娠并宫颈机能不全诊治中的应用

Application of B Ultrasound of Monitoring Cervical Length and Cervical Cerclage in Diagnosing Twin Pregnancy and Cervical Incompetence

目的：探讨B超在监测双胎妊娠并宫颈机能不全方面的应用,以及宫颈环扎术在治疗双胎妊娠并宫颈机能不全的应用意义。方法：对2011年8月～2014年8月某院行围产保健的316例双胎妊娠孕妇自孕13周开始定期行B超监测宫颈长度,孕期超声发现宫颈机能不全,行治疗性宫颈环扎术的19例双胎妊娠病例进行回顾性分析。结果：双胎妊娠中发生宫颈机能不全比率高于单胎妊娠。B超作为有效的监测方法,能及时发现宫颈机能不全。所有宫颈机能不全患者均行宫颈环扎术,宫颈环扎术能显著延长双胎妊娠孕龄,延长孕龄为8～20周,获得满意疗效。结论：双胎妊娠中流产率、早产率,出生儿低体重率及围产儿死亡率等均较高,严重影响了出生人口素质及母亲的身心健康。笔者在研究中发现双胎妊娠宫颈机能不全发生率高于单胎妊娠,将双胎妊娠纳入高危妊娠范畴,加强监护,定期B超严密监测宫颈长度,早期诊断宫颈机能不全,及时行宫颈环扎术,能明显延长孕周,降低流产率、早产率,从而降低了低体重儿发生率及围产儿死亡率[1]。

Objective： To investigate the application and significance of B ultrasound and cervical cerclage in the monitoring of twin pregnancy and cervical incompetence. Methods： 316 cases of twin pregnancy in a hospital received from August 2011 to August 2014 were treated with B ultrasound in monitoring the length of cervix from the 13th week of the pregnancy, who were found cervical incompetence during pregnancy. Then retrospectively analyze 1 9 cases undergoing cervical cerclage.Results： The rate of occurrence of cervical incompetence in twin pregnancy was higher than that of single pregnancy. B ultrasound as an effective moni toring method, can timely find the cervical incompetence. All of the patients with cervical function underwent cervical cerclage which can significantly prolong the twin pregnancy gestational age, extending gestational age for 8 to 20 weeks and has obtained satisfactory curative effect.Conclusion： Abortion rate, premature de livery rate, born of low weight rate and perinatal mortality of twin pregnancy are higher, seriously affecting the birth population quality, and the mother＇s physical and mental health. In the study, the author found that twin pregnancy cervical incompetence is higher than that of the single pregnancy. Taking twin pregnancy into high-risk pregnancy category, strengthening intensive care, closely monitoring cervical length and early diagnosing cervical incompetence, and treating with timely cervical cerclage can obviously prolong the gestational, reduce abortion rate, premature delivery rate, thereby reducing the incidence of low birth weight rate and perinatal mortalitye.