宫颈机能不全患者采用不同指证McDonald子宫颈环扎术对足月分娩的影响

The influence of McDonald cervical cerclage based on different indications for treating pregnant women with cervical insufficiency on their full-term delivery

目的:探讨不同指证McDonald子宫颈环扎术对宫颈机能不全患者足月分娩影响。方法:回顾性收集2016年8月-2018年10月本院治疗的宫颈机能不全患者102例。根据McDonald的手术时机不同分为3组各34例。病史指证组行基于病史指征性的McDonald子宫颈环扎术,阴道超声组采取经阴道彩色超声联合McDonald子宫颈环扎术,体格指证组行体格检查指征性环扎术。对比3组手术成功率、妊娠结局、新生儿情况。结果:成功率、分娩孕周、足月分娩率、新生儿体质量及存活率,病史指证组及阴道超声组均高于体格指证组(P<0.05),但病史指证组与阴道超声组对比无差异(P>0.05)。流产率、早产率3组无差异(P>0.05)。结论:不同手术指征对McDonald子宫颈环扎术治疗宫颈机能不全效果存在差异,经阴道彩超联合McDonald子宫颈环扎术及基于病史指征性的McDonald子宫颈环扎术手术成功率、分娩孕周、足月分娩率、新生儿体质量及存活率均优于体格检查指征性环扎术。

Objective:To investigate the influence of McDonald cervical cerclage based on different indications for treating women with cervical insufficiency on their full-term delivery rate.Methods:The data of 102 pregnant women with cervical insufficiency from August 2016 to October 2018 were collected,and these women were divided into 3 groups according to different indications of McDonald cervical cerclage(34 cases in each group).The indications of McDonald cervical cerclage of women in group A were based on medical history,in group B were based on transvaginal color ultrasound,and in group C were based on vaginal examination.The success rate of surgical,pregnancy outcomes,and neonatal status were compared among the three groups.Results:The success rate of surgical,gestational weeks when delivery,the rate of full-term delivery,and neonatal body mass index(BMI),and survival rate of group A and B were significant higher than those of group C(P<0.05),but those of group A had no significant different to those of group B(P>0.05).There were no difference in abortion rate and premature delivery rate among the 3 groups(P>0.05).Conclusion:Different surgical indications of McDonald cervical cerclage for treating cervical incompetence have different effect.Compare to those of the indication of McDonald cervical cerclage based on physical examination,the indication of McDonald cervical cerclage based on transvaginal color Doppler ultrasound or medical history have higher success rate of surgical,gestational weeks when delivery,the rate of full-term delivery,and neonatal body mass index(BMI)and survival rate.