择期对宫颈功能不全孕妇行宫颈环扎术治疗对母婴妊娠结局的影响

Impact of Elective Cervical Cerclage Placement in Pregnant Women with Cervical Insufficiency on Maternal Pregnancy Outcomes

目的探讨择期对宫颈功能不全孕妇行宫颈环扎术治疗对母婴妊娠结局的临床影响。方法80例宫颈功能不全孕妇随机分组(对照组、观察组,每组例数为40例),就诊于2020年2月至2021年11月,患者均接受宫颈环扎术治疗,但对照组为紧急宫颈环扎术,观察组接受择期宫颈环扎术,比较两组母婴妊娠结局、血液指标等。结果观察组宫内感染率30.00%、晚期流产率25.00%低于对照组宫内感染率65.00%、晚期流产率47.50%,足月分娩率57.50%高于对照组30.00%,差异有统计学意义(χ^(2)=9.825、4.381、5.079,P<0.05);两组早产率(17.50%vs.22.50%)比较,差异无统计学意义(χ^(2)=0.082,P>0.05);两组新生儿出生体质量、孕周延长时间、孕妇住院时间、新生儿Apgar评分比较,差异无统计学意义(P>0.05);两组术前CRP、PCT指标比较,差异无统计学意义(P>0.05),术后1、3、5 d时,观察组CRP、PCT低于对照组,差异有统计学意义(P<0.05);观察组绒毛膜羊膜炎发生率2.50%低于对照组15.00%(P<0.05);两组宫颈裂伤发生率(2.50%vs.2.50%)、胎膜早破率(2.50%vs.0)比较,差异无统计学意义(P>0.05)。结论宫颈功能不全孕妇接受治疗时选用择期宫颈环扎术,可显著改善母婴妊娠结局,且可更好的控制患者机体血液指标。

Objective To investigate the clinical effect of elective treatment with cervical cerclage in pregnant women with cervical insufficiency on the outcomes of mother and child pregnancy.Methods A total of 80 pregnant women with cervical insufficiency(40 cases in each group)were randomly assigned(control group,observation group)to study the treatment of cervical cerclage in each patient from February 2020 to November 2021,but the control group was emergency cervical cerclage and the observation group received elective cervical cerclage,and the maternal pregnancy outcomes,blood indicators and other parameters were compared between the two groups.Results The observed group had 30.00%intrauterine infection rate,25.00%late abortion rate lower than the control group's 65.00%intrauterine infection rate,47.50%late abortion rate,and 57.50%term delivery rate higher than the control group's 30.00%,respectively(χ^(2)=9.825,4.381,5.079,P<0.05).There was no significant difference when comparing the preterm delivery rate(17.50%vs.22.50%)(χ^(2)=0.082,P>0.05).We compared neonatal birthweight,gestational week extension,duration of maternal hospital stay,and neonatal Apgar scores(P>0.05).The CRP and PCT indexes before operation were compared(P>0.05),and at 1,3,5 day after operation,CRP and PCT were lower than those of the control group,with significant differences(P<0.05).The incidence of chorioamnionitis in the observation group was 2.50%lower than that in the control group by 15%(P<0.05),cervical laceration(2.50%vs.2.50%),and premature rupture of membranes(2.50%vs.0)(P>0.05).Conclusion Elective cervical cerclage when pregnant women with cervical insufficiency are treated can significantly improve maternal pregnancy outcomes,and can better control body blood indicators in patients.