宫颈环扎术治疗三胎妊娠合并宫颈机能不全二例

Two Cases of Triplet Pregnancy with Cervical Incompetence Treated by Cervical Cerclage

三胎妊娠围产期并发症和合并症较单胎和双胎妊娠明显升高,其中最值得关注的是早产和早产儿发病及死亡,如果三胎妊娠合并宫颈机能不全则流产或早产的风险更高。报道2例通过辅助生殖技术受孕的三胎妊娠(双绒毛膜三羊膜囊)合并宫颈机能不全患者,1例孕前行腹腔镜宫颈环扎术,另1例在孕15+5周行经阴道宫颈环扎术,孕期均定期产检阴道超声监测宫颈长度并及时治疗预防早产,分别在孕33+2周和孕33+3周成功剖宫产分娩三活婴。对于不愿意采用减胎术的三胎妊娠合并宫颈机能不全患者,宫颈环扎术是一个可靠的治疗方案,定期随访对防治早产、指导临床用药及适时拆除宫颈环扎线并改善母儿预后至关重要。

Perinatal complications and comorbidities are significantly more common in triplets pregnancies than in single and twin pregnancies,the most significant of which are preterm and preterm birth morbidity and mortality.The risk of miscarriage or preterm birth increases if triplet pregnancies are combined with cervical incompetence.The paper reports two cases of dichorionic triamniotic triplet pregnancies conceived by assisted reproductive technology complicated with cervical incompetence.One case underwent preconception laparoscopic cervical cerclage,and the other underwent transvaginal cervical cerclage at 15+5 weeks of gestation.Regular vaginal ultrasound monitoring of cervical length and timely treatment to prevent premature birth were peformed during pregnancy.Three live babies were delivered by cesarean section at 33+2 weeks and 33+3 weeks respectively.Cervical cerclage is a reliable treatment option,especially for those opting against fetal reduction.Regular follow-up is very important for preventing premature birth,guiding clinical medication,timely removal of cervical cerclage and improving the prognosis of mother and child.