妊娠期择期宫颈环扎术手术时间探讨

Evaluation on the operation time of elective cervical cerclage during pregnancy

目的评价孕期行择期宫颈环扎术手术时间与妊娠结局的关系。方法回顾性分析广东省9家医院宫颈机能不全病例共554例,其中孕期行择期宫颈环扎术112例,分别比较13~16周、16~26周及14~18周手术组与其他孕周行宫颈环扎手术的妊娠结局。结果 13~16周手术组足月分娩率(56.9%)高于16周以上组(44.3%)(χ~2=3.834,P=0.039),晚期流产率(17.6%)低于16周以上组(31.1%)(χ~2=6.019,P=0.014);16~26周及14~18周手术组与其他孕周手术组相比,足月分娩率、早产率、晚期流产率及新生儿平均体重均无统计学差异(P>0.05)。结论妊娠13~16周行择期宫颈环扎术能有效增加足月分娩率、减少晚期流产率。

Objective To evaluate the relationship between gestational age at surgery and pregnant outcomes on elective cervical cerclage. Methods A retrospective analysis was carried out on 554 patients of cervical insufficiency in 9 hospitals in Guangdong province. There were 112 pregnant women suffered from elective cervical cerclage. Pregnancy outcomes was compared according to different gestational age at surgery on elective cervical cerclage. Results 13-16 weeks operation group had significant higher preterm delivery rate(χ~2=3.834, P=0.039) and lower late abortion rate than over 16 weeks operation group(χ~2=6.019, P=0.014). In 16-26 and 14-18 weeks operation groups, full-term delivery rate, preterm delivery rate, rates of late abortion and average weight of newborns had no significant differences than the other gestational age surgery group(P>0.05). Conclusion Elective cervical cerclage done in 13-16 weeks of pregnancy may improve pregnant outcomes better than the other period in pregnancy.