不同方法治疗孕中期宫颈机能不全妊娠结局的比较

Comparison of pregnancy outcomes of cervical incompetence patients during the second trimester of pregnancy treated by different methods

目的探讨不同方法治疗孕中期宫颈机能不全对妊娠结局的影响。方法选择孕中期宫颈机能不全产妇94例,根据治疗方法分为4组:择期宫颈环扎术组(A组)、应激性宫颈环扎术组(B组)、紧急宫颈环扎术组(C组)及保守期待疗法组(对照组)。记录患者的临床信息,并进行常规检查,术后统计胎儿存活率,分析不同治疗方法对妊娠结局及并发症发生影响。结果与对照组相比,A、B及C组的存活率均明显升高(P<0.05),三组的存活率差异无统计学意义(P>0.05);A、B及C组的足月分娩率、分娩孕周、顺产率及新生儿体重明显高于对照组(P<0.05),而早产率及晚期流产率显著低于对照组(P<0.05);A、B及C组并发症发生率均明显低于对照组(P<0.05)。结论对孕中期宫颈机能不全患者行宫颈环扎术可以提高婴儿的存活率,改善孕妇的妊娠结局,降低并发症的发生率,不同的宫颈环扎术之间并无差异,需要根据孕妇的具体情况实施手术。

Objective To explore the effects of different methods on pregnancy outcomes in treatment of cervical incompetence patients during the second trimester of pregnancy. Methods Ninety-four pregnant women with cervical incompetence during the second trimester of pregnancy were selected and divided into group A （elective cervical cerclage surgery）, group B （irritable cervical cerclage）, group C （e- mergency cervical cerclage）, and control group （conservative expectant treatment） according to therapeutic method. The clinical information was recorded, regular examination was conducted, fetal survival rate was analyzed statistically, the effects of different therapeutic methods on pregnancy outcomes and complications were analyzed. Results Compared with control group, the survival rates in group A, group B, and group C increased significantly （P〈0. 05 ）, there was no statistically significant difference among the three groups （P〉0. 05 ） ; full-term delivery rates, gestational weeks in labor, natural labor rates, and neonatal weights in group A, group B, and group C were statistically signifi- cantly higher than those in control group （ P〈0.05 ）, while premature delivery rates and late abortion rates in group A, group B, and group C were statistically significantly lower than those in control group （P〈0.05） ; the incidence rates of complications in group A, group B, and group C were statistically significantly lower than that in control group （ P〈0. 05 ） . Conclusion Cervical cerclage can improve the survival rate of infants born by cervical incompetence patients during the second trimester of pregnancy and pregnancy outcomes, reduce incidence rate of complications. There is no difference among different cervical cerclage methods, cervical cerclage need to be carried out according to the specific situation of pregnant women.