应激性宫颈环扎术对双胎妊娠短宫颈患者妊娠结局影响的临床研究

Clinical study on the effect of stress cervix ligation on pregnancy outcome in patients with short cervix of twin pregnancy

目的比较分析无症状经阴道彩超测量10mm≤宫颈长度≤20mm双胎妊娠患者采用宫颈环扎术或期待治疗的妊娠结局。方法回顾性分析2013年1月至2017年12月就诊于中山大学孙逸仙纪念医院经阴道彩超检查10mm≤宫颈长度≤20mm的无症状孕17～27^(+6)周双胎妊娠患者57例,其中41例行应激性宫颈环扎术为手术组,16例行期待治疗为对照组。结果手术组诊断孕周(22.70±2.54)周,早于对照组的(25.79±1.59)周,妊娠延长时间为(72.29±22.88)d,长于对照组的(44.94±22.64)d,差异均有显著性(P<0.05)。两组在胎膜早破发生率、分娩孕周、<26周分娩率、<28周分娩率、<32周分娩率、<34周分娩率等方面,差异无显著性(P>0.05)。结论孕17～27^(+6)周的双胎妊娠患者,10mm≤宫颈长度≤20mm时,应激性宫颈环扎术相较于期待治疗能更久地延长妊娠时间。

Objective To evaluate the effectiveness of cerclage performed on the asymptomatic twin pregnancy with 10 mm≤cervix length≤20 mm were examined by transvaginal color ultrasound between 17-27+6 weeks. Method This is a retrospective cohort study of 57 cases of twin pregnancies from January 2013 to December 2017,who were discharged from Sun Yat-sen Memorial Hospital of Sun Yat-sen University, and with 10 mm≤cervix length≤20 mm were examined by transvaginal color ultrasound. In all, 57 women were included in two cohorts: cerclage(n= 41) or no cerclage(n=16). Result The gestational weeks in the operation group were(22.70±2.54) weeks, earlier than(25.79±1.59) weeks in the control group, and the prolongation time was(72.29±22.88) days, longer than that in the control group(44.94±22.64) days(P<0.05). There was no signifi cant difference between the two groups in the incidence of premature rupture of membranes, the average gestational week of delivery, <26 weeks, 28 weeks, 32 weeks and 34 weeks of delivery(P>0.05). Conclusion In the asymptomatic twin pregnancies with 10 mm≤cervix length≤20 mm between 17-27+6 weeks, urgent cerclage can prolong the pregnancy time when comparing with expectant treatment.