摘要
目的:探讨前次妊娠宫颈环扎手术指征对本次预防性宫颈环扎术后妊娠结局的影响。方法:本研究为一项前瞻性队列研究,选取2022年1月至2025年1月于福建省妇幼保健院行预防性宫颈环扎术的60例单胎妊娠宫颈机能不全(cervical incompetence, CI)患者,所有患者既往均有一次妊娠行宫颈环扎术史。根据前次妊娠宫颈环扎手术指征将患者分为病史指征组、超声指征组和体检指征组。比较三组基线资料、妊娠分娩结局、新生儿结局、妊娠并发症及新生儿并发症。结果:病史指征组、超声指征组和体检指征组的年龄、孕前体质指数(body mass index, BMI)、孕产次、妊娠间隔时间、本次环扎术前宫颈闭合线长度以及分娩方式比较,差异无统计学意义(P>0.05)。病史指征组中晚孕期流产次数高于超声指征组和体检指征组,差异具有统计学意义(P<0.05)。病史指征组在分娩孕周、新生儿体重、1 min Apgar评分均显著优于超声指征组和体检指征组(P<0.05),超声指征组在分娩孕周、新生儿体重、1 min Apgar评分显著优于体检指征组(P<0.05)。病史指征组、超声指征组和体检指征组在胎膜早破、产后出血、宫颈裂伤及新生儿并发症比较,差异无统计学意义(P>0.05)。结论:前次以病史指征行妊娠宫颈环扎术的CI患者其本次妊娠的妊娠结局显著优于前次以超声指征或体检指征行环扎术的患者。
Objective:To explore the impact of the indications for previous cervical cerclage on the pregnancy outcomes after this prophylactic cervical cerclage.Method:This study was a prospective cohort study,60 patients with cervical incompetence(CI)in singleton pregnancies who underwent preventive cervical cerclage at Fujian Maternal and Child Health Hospital from January 2022 to January 2025 were selected.All patients had a history of cervical cerclage during one previous pregnancy.According to the indications for cervical cerclage in the previous pregnancy,the patients were divided into the medical history indication group,ultrasound indication group and physical examination indication group.The baseline data,pregnancy delivery outcome,neonatal outcome,pregnancy complications and neonatal complications were compared among three groups.Results:Comparison of age,pre pregnancy body mass index(BMI),number of pregnancies,interval between pregnancies,the length of cervical closure line before this cerclage surgery,and delivery mode among the medical history indication group,ultrasound indication group and physical examination indication group,the difference is not statistically significant(P>0.05).The number of miscarriages during mid to late pregnancy in the medical history indication group was higher than that in the ultrasound indication group and physical examination indication group,and the difference was statistically significant(P<0.05).The medical history indication group showed significantly better outcome than the ultrasound indication group and physical examination indication group in terms of delivery gestational week,newborn weight and 1 min Apgar score(P<0.05),The ultrasound indication group showed significantly better outcome than the physical examination indication group in terms of delivery gestational week,newborn weight and 1 min Apgar score(P<0.05).Comparison of medical history indication group,ultrasound indication group and physical examination indication group in terms of premature rupture of membranes,postpartum hemorrhage,cervical laceration and neonatal complications,the difference is not statistically significant(P>0.05).Conclusion:The pregnancy outcome of CI patients who underwent cervical cerclage based on medical history indications in the previous pregnancy was significantly better than that of patients who underwent cerclage based on ultrasound indications or physical examination indications in the previous pregnancy.
作者
徐圆圆
许志敏
邱洛洁
潘勉
XU Yuan-yuan;XU Zhi-min;QIU Luo-jie;PAN Mian(Department of Gynaecology and Obstetrics,Minqing County General Hospital,Fuzhou,Fujian,350800,China;Department of Obstetrics,Fujian Maternal and Child Health Hospital,Fuzhou,Fujian,350001,China)
出处
《现代生物医学进展》
2025年第21期3478-3484,共7页
Progress in Modern Biomedicine
基金
福建省科学技术厅医疗卫生领域省科技创新联合基金项目(2024Y9556)。
关键词
宫颈机能不全
手术指征
宫颈环扎术
妊娠结局
Cervical incompetence
Surgical indications
Cervical cerclage
Pregnancy outcome
