二次宫颈锥形切除或广泛宫颈切除术后并行宫颈环扎的患者妊娠结局分析

Analysis of pregnancy outcomes after secondary cervical conization or radical trachelectomy and transvaginal cervical cerclage

目的:分析二次宫颈锥形切除或广泛宫颈切除术后患者的妊娠结局。方法:选取2012年9月至2022年12月于郑州大学第一附属医院接受二次宫颈锥形切除或广泛宫颈切除术后并行宫颈环扎的单胎妊娠孕妇26例,分析其妊娠结局。结果:26例手术过程均顺利,无一例中转开腹。11例妊娠,其中6例足月剖宫产,2例早产,3例流产。非妊娠组与妊娠组之间年龄、出血量、宫颈切除体积及宫颈切除高度差异均无统计学意义(P>0.05)。宫颈切除体积>4 cm^(3)者中,足月产率(1/3)低于≤4 cm^(3)者(5/8)。术后至妊娠的间隔时间≤12个月者中,足月产率(1/4)小于>12个月者(5/7)。结论:减少宫颈切除体积和手术后延迟妊娠可以改善二次宫颈锥形切除或广泛宫颈切除术后的妊娠结局。

Aim:To investigate pregnancy outcomes after secondary cervical conization or radical trachelectomy and transvaginal cervical cerclage.Methods:A total of 26 singleton patients who underwent secondary cervical conization or radical trachelectomy and transraginal cervical cerclage in the First Affiliated Hospital of Zhengzhou University from September 2012 to December 2022 were selected,and their perinatal outcomes were analyzed.Results:All the 26 patients underwent successful operation,and no one was converted to laparotomy.There were 11 pregnancies,out of which,6 were delivered by cesarean at full term,2 were premature birth,and 3 were miscarriages.There was no significant difference in age,blood loss,resection volume,or conization height between the non-pregnant group and the pregnant group(P>0.05).The full-term birth rate of patients with the resection volume>4 cm^(3)(1/3)was lower than that(5/8)of the patients with≤4 cm^(3).The full-term birth rate of patients with pregnancy interval≤12 months(1/4)was less than that(5/7)of the patients with>12 months.Conclusion:Reducing the resection volume and delaying pregnancy after surgery can improve the perinatal outcomes after secondary cervical conization or radical trachelectomy.