双胎妊娠紧急宫颈环扎术一例并文献复习

Emergency Cervical Cerclage in Twin Pregnancies:A Case Report and Literature Review

早产是围生儿死亡的主要原因。双胎妊娠早产发生率高,宫颈机能不全(cervical incompetence,CIC)是其原因之一。目前全球尚无指南推荐的方法预测双胎CIC,其诊断也主要基于病史和体格检查结果,经超声预测和诊断困难,且治疗方法和效果评价也存在争议。现报道1例双胎妊娠在孕22+4周,无宫缩,宫颈扩张4 cm,排除感染后,经阴道以W6977缝线行双重紧急环扎,延长孕周50 d,分娩2活婴,介绍其临床诊治过程,并复习近年国内外双胎妊娠CIC紧急环扎治疗进展的相关文献。

Preterm birth is the leading cause of perinatal mortality.The incidence of preterm birth in twin pregnancies is high,and one of the reasons is cervical incompetence(CIC).Now there are no guidelines recommended in the world to predict CIC in twin pregnancies.The diagnosis is also based on medical history and physical examination.Prediction and diagnosis by ultrasound are difficult.The treatment methods and evaluation of effects are also controversial.We report a case for twin pregnancies which undergo emergency cervical cerclage with suture W6977 at 22+4 weeks gestation with the cervix dilated by 4 cm and infection is ruled out.The time from cerclage placement to delivery were 50 days with 2 live babies were born.The current research of the diagnosis and treatment for CIC in twin pregnancies is reviewed.