腹腔镜下孕前及孕期宫颈环扎98例妊娠结局分析

Analysis of Pregnancy Outcome of 98 Cases of Cervical Cerclage Before and During Pregnancy Under Laparoscope

目的:探讨宫颈功能不全患者在孕前及孕期实行腹腔镜宫颈环扎对妊娠结局的影响。方法:从本院2018年3月~2019年3月接诊的宫颈功能不全患者中选择98例。根据不同时间段宫颈环扎将患者分为对照组与观察组,两组各49例。对照组在孕期宫颈环扎,观察组则在孕前环扎。对比两组患者的手术情况和妊娠结局。结果:观察组患者术中出血量少于对照组,P<0.05,符合统计学意义;但对照两组妊娠期宫颈长度、孕周延长天数与围产儿体质量,并无明显区别,P>0.05,无统计学意义;对比两组患者妊娠结局,各项指标并无明显区别,P>0.05,不符合统计学意义。结论:针对宫颈功能不全,于腹腔镜下孕前及孕期宫颈环扎效果较好,有助于保持患者宫颈长度,延长孕周,对改善妊娠结局具有显著的效果,特别是孕期环扎失败患者效果更理想。

Objective:To investigate the effect of laparoscopic cervical cerclage on pregnancy outcome in patients with cervical insufficiency before and during pregnancy.Methods:From March 2018 to March 2019,98 patients with cervical insufficiency were selected.The patients were divided into control group and observation group according to different periods of cervical cerclage.There were 49 cases in both groups.The control group had cervical cerclage during pregnancy,while the observation group had cervical cerclage before pregnancy.The results of operation and pregnancy were compared between the two groups.Results:The amount of bleeding in the observation group was less than that in the control group(P<0.05),the difference was statistically significant(P<0.05),but there was no significant difference(P>0.05)between the length of cervix during pregnancy,the days of prolonged gestation and the weight of perinatal body in the control group(P>0.05),and there was no significant difference between the two groups(P>0.05).Conclusion:In view of cervical insufficiency,the effect of cervical cerclage before and during pregnancy under laparoscope is better,which is helpful to maintain the length of cervix and prolong the gestational period,and has significant effect on improving the pregnancy outcome,especially for the patients with failed cerclage during pregnancy.