紧急宫颈环扎术对宫颈机能不全产妇妊娠结局及新生儿Apgar评分的影响

Effect of Emergency Cervical Cerclage on Pregnancy Outcomes and Neonatal Apgar Score in Puerperae with Cervical Incompetence

目的:研究紧急宫颈环扎术对宫颈机能不全产妇妊娠结局及新生儿Apgar评分的影响。方法:回顾性选取2021年1月—2023年9月在赣州市妇幼保健院分娩的80例宫颈机能不全孕妇作为研究对象,根据其是否进行紧急宫颈环扎术分为环扎组(n=40,采用紧急宫颈环扎术治疗)和未环扎组(n=40,采用常规药物治疗)。收集两组临床相关资料,比较两组足月生产率、妊娠结局、新生儿出生不同时间点(1、5、10 min)Apgar评分、出生体重、延长孕周及临床治疗满意程度,记录环扎组手术并发症发生情况。结果:环扎组妊娠32周子宫颈长度长于未环扎组,延长孕周长于未环扎组,差异均有统计学意义(P<0.05)。环扎组足月生产率为50.00%(20/40),高于未环扎组的12.50%(5/40),差异有统计学意义(P<0.05)。环扎组活产率为92.50%(37/40),高于未环扎组的75.00%(30/40),环扎组的孕晚期流产率为7.50%(3/40),低于未环扎组的25.00%(10/40),环扎组自然分娩率为85.00%(34/40),高于未环扎组的57.50%(23/40),差异均有统计学意义(P<0.05)。环扎组新生儿出生1、5、10 min的Apgar评分均高于未环扎组,差异均有统计学意义(P<0.05)。环扎组临床治疗满意度为77.50%(31/40),高于未环扎组的50.00%(20/40),差异有统计学意义(P<0.05)。环扎组40例中有1例发生感染、1例发生子宫颈裂伤,并发症发生率为5.00%(2/40)。结论:紧急宫颈环扎术可有效延长宫颈机能不全孕妇的孕周,降低流产率,提高新生儿Apgar评分,保障母婴健康,且临床治疗满意度较高。

Objective:To study the effects of emergency cervical cerclage on pregnancy outcomes and neonatal Apgar score in puerperae with cervical incompetence.Method:A total of 80 pregnant women with cervical incompetence who gave birth in Ganzhou Women and Children's Health Care Hospital from January 2021 to September 2023 were retrospectively selected as the research objects.According to whether they had emergency cervical cervix,they were divided into the cerclage group(n=40,emergency cervical cervix treatment)and the noncerclage group(n=40,conventional drug treatment).The clinical data in the two groups were collected.The full-term delivery rate,pregnancy outcomes,neonatal Apgar scores at different time points(1,5 and 10 min),birth weight,extended gestational age and satisfaction of clinical treatment in the two groups were compared,the incidence of surgical complications in the non-cerclage group was recorded.Result:The cervical length at 32 weeks gestation in the cerclage group was longer than that in the non-cerclage group,and the extended gestation period was longer than that in the non-cerclage group,the differences were statistically significant(P<0.05).The full-term productivity of the cerclage group was 50.00%(20/40),higher than 12.50%(5/40)of the non-cerclage group,the difference was statistically significant(P<0.05).The live birth rate of the cerclage group was 92.50%(37/40),higher than 75.00%(30/40)of the non-cerclage group,the late pregnancy abortion rate of the cerclage group was 7.50%(3/40),lower than 25.00%(10/40)of the non-cerclage group,and the natural delivery rate of the cerclage group was 85.00%(34/40),higher than 57.50%(23/40)in the non-cerclage group,the differences were statistically significant(P<0.05).Apgar scores in the cerclage group 1,5 and 10 min after birth were higher than those in the non-cerclage group,the differences were statistically significant(P<0.05).The satisfaction of clinical treatment was 77.50%(31/40)in the cerclage group,which was higher than 50.00%(20/40)in the non-cerclage group,the difference was statistically significant(P<0.05).In the cerclage group,1 case of infection and 1 case of cervical laceration occurred,and the complication rate was 5.00%(2/40).Conclusion:Emergency cervical cerclage can effectively prolong gestational age of pregnant women with cervical incompetence,reduce abortion rate,increase neonatal Apgar scores and ensure maternal and neonatal health,with high satisfaction with clinical treatment.