体外受精-胚胎移植中孕前宫颈管长度≤3cm患者的中晚期妊娠结局

Middle-late pregnancy outcomes of patients with cervical length no more than 3 cm before pregnancy in-vitro fertilization and embryo transfer treatment

目的 测量体外受精-胚胎移植（IVF-ET）患者孕前宫颈管长度,随访宫颈管长度≤3 cm并获得临床妊娠患者的中晚期妊娠结局.方法 回顾性分析2009年5月至2014年12月在我中心行IVF-ET且宫颈管长度≤3 cm的临床妊娠患者86例,其中早期流产8例,将其余78例作为研究组随访其中晚期妊娠结局;用SPSS软件随机抽取我中心同时期宫颈管长度〉3 cm且获得临床妊娠的患者225例,其中早期流产32例,将其余193例作为对照组随访其中晚期妊娠结局.分别比较不同宫颈管长度组中单胎妊娠组（单胎1组和单胎3组）和双胎妊娠组（双胎2组和双胎4组）的晚期流产率、早产率,分析宫颈管长度≤3 cm者发生不良中晚期妊娠结局的风险.结果 孕前测量宫颈管长度≤3 cm患者中单胎妊娠组（单胎1组）发生晚期流产的比例明显高于宫颈管长度〉3 cm中单胎妊娠组（单胎3组）（18.7%比7.3%）（P〈 0.05）,但两组间早产患者的比例（14.5%比9.3%）比较差异未见统计学意义（P〉0.05）;孕前测量宫颈管长度≤3 cm患者中双胎妊娠组（双胎2组）与宫颈管长度〉3 cm中双胎妊娠组（双胎4组）相比,两组晚期流产比例（33.3%比19.5%）和早产比例（20.0%比19.6%）比较差异未见统计学意义（P〉0.05）.结论 IVF-ET中孕前测量宫颈管长度≤3 cm者发生不良中晚期妊娠结局的风险增加.

Objective To evaluate the middle-late pregnancy outcomes of patients who were clinical pregnancy with cervical length no more than 3 cm before pregnancy in-vitro fertilization and embryo transfer （IVF-ET） treatment.Methods A retrospective analysis was performed on infertile women with embryo transfer from May 2009 to December 2014 in our center.There were 86 patients who were clinical pregnancy with cervical length no more than 3 cm on transfer day, among whom 8 cases were miscarriage, and the rest 78 patients with ongoing pregnancy as study groups.A total of 225 patients whose clinical pregnancy with cervical length more than 3 cm as control groups, among whom 32 cases were miscarriage and the rest 193 patients with ongoing pregnancy.By comparing different cervical length of single pregnancy group （single pregnancy group 1 and group 3） and the twin pregnancy group （twins pregnancy group 2 and group 4） late miscarriage rate, premature birth rate respectively, the risks of adverse middle-late pregnancy outcomes in patients with cervical length no more than 3 cm were analyzed.Results The proportion of patients with cervical length no more than 3 cm before pregnancy in single pregnancy group 1 was significantly higher than the cervical length more than 3 cm in single pregnancy group 3（18.7% vs.7.3%）（P〈 0.05）, but the proportion of patients with premature birth between the two groups （14.5% vs.9.3%）, there was no significant difference （P〉0.05）.Meanwhile, there was no significant difference in the proportion of late miscarriage between the patients with cervical length more than 3 cm before pregnancy in twins pregnancy group 4 and patients with cervical length no more than 3 cm before pregnancy in twins pregnancy group 2（33.3% vs.19.5%）, as well as the premature birth（20.0% vs.19.6%）（P〉0.05）.Conclusion The adverse middle-late pregnancy outcome might be more likely happen in patients with cervical length no more than 3 cm before pregnancy.