摘要
目的探讨紧急宫颈环扎术后延长孕周的影响因素。方法回顾性纳入2019年1月1日至2022年9月1日于嘉兴市妇幼保健院诊断宫颈机能不全并于孕12~26周行紧急宫颈环扎术的单胎妊娠孕妇88例,28周后分娩者作为环扎成功组(n=77),<28周分娩/流产者作为环扎失败组(n=11)。采用两独立样本t检验或Mann-Whitney U检验进行组间比较,采用单因素分析和多个回归方程筛选术后延长孕周的影响因素。结果紧急宫颈环扎术环扎成功率(≥28周分娩率)为87.5%(77/88),其中孕28~31周+6分娩者6例(6/77,7.8%),孕32~33周+6分娩者2例(2/77,2.6%),孕34~36周+6分娩者16例(16/77,20.8%),≥37周分娩者53例(53/77,68.8%)。多个回归方程分析结果显示早孕期流产3次(β=-5.1,95%CI:-9.5~-0.7)、早孕期流产5次(β=-11.8,95%CI:-22.1~-1.6)、产次2次(β=-6.9,95%CI:-12.9~0.9)、环扎孕周(β=-0.6,95%CI:-1.0~-0.3)、环扎术前宫颈外口扩张<15 mm(β=-12.1,95%CI:-22.5~-1.8)和环扎术前宫颈外口扩张≥15 mm(β=-11.0,95%CI:-21.4~-0.71)是环扎术后延长孕周的影响因素;校正孕妇年龄及宫颈环扎术前体重后,早孕期流产5次(β=-18.1,95%CI:-28.3~-7.8)、环扎孕周(β=-0.6,95%CI:-1.0~-0.3)和环扎术前宫颈外口扩张≥15 mm(β=-11.4,95%CI:-21.2~-1.6)是环扎术后延长孕周的影响因素(P值均<0.05)。结论早孕期流产次数、环扎孕周及环扎术前宫颈外口扩张≥15 mm是影响紧急宫颈环扎术后延长孕周的因素。
Objective To investigate the factors that influence the prolongation of gestation following emergency cervical cerclage.MethodsThis retrospective study included 88 singleton pregnant women who were diagnosed with cervical incompetence and underwent emergency cervical cerclage at 12-26 weeks of gestation in the Jiaxing Maternity and Child Health Care Hospital from January 1,2019 to September 1,2022.The participants who delivered after 28 gestational weeks were assigned to the success group(n=77),while those who delivered or miscarried before 28 gestational weeks were assigned to the failure group(n=11).Two independent sample t-test or Mann-Whitney U test was used for comparison between groups.The factors affecting the prolongation of gestation after the procedure were selected by univariate analysis and multiple regression equations.ResultsThe success rate(delivery rate≥28 weeks)was 87.5%(77/88).There were six women delivered at 28-31+6 weeks of gestation(6/77,7.8%),two at 32-33+6 weeks of gestation(2/77,2.6%),16 at 34-36+6 weeks of gestation(16/77,20.8%),and 53 at 37 weeks of gestation or later(53/77,68.8%).Multiple regression analysis indicated that three times of early pregnancy miscarriage(β=-5.1,95%CI:-9.5 to-0.7),five times of early pregnancy miscarriage(β=-11.8,95%CI:-22.1 to-1.6),had two live births(β=-6.9,95%CI:-12.9 to-0.9),gestational age at cerclage(β=-0.6,95%CI:-1.0 to-0.3),external cervical os dilation<15 mm(β=-12.1,95%CI:-22.5 to-1.8)and≥15 mm before cerclage(β=-11.0,95%CI:-21.4 to-0.71)were factors affecting the prolongation of gestation after cerclage.After adjusting for maternal age and weight before emergency cervical cerclage,five times of early pregnancy miscarriage(β=-18.1,95%CI:-28.3 to-7.8),gestational age at cerclage(β=-0.6,95%CI:-1.0 to-0.3),and external cervical os dilation≥15 mm before cerclage(β=-11.4,95%CI:-21.2 to-1.6)remained the significant influencing factors(all P<0.05).ConclusionThe number of early pregnancy miscarriages,gestational age at cerclage,and the width o
作者
朱伟英
艾玲
严琴芳
马蔷
项生群
顾一鸣
Zhu Weiying;Ai Ling;Yan Qinfang;Ma Qiang;Xiang Shengqun;Gu Yiming(Department of Obstetrics,Jiaxing Maternity and Child Health Care Hospital(Jiaxing Women and Children's Hospital,Wenzhou Medical University),Jiaxing 314000,China)
出处
《中华围产医学杂志》
CAS
CSCD
北大核心
2024年第8期662-667,共6页
Chinese Journal of Perinatal Medicine
基金
嘉兴市公益性研究计划(2021AD30131)
嘉兴市科技计划项目(2023AD31118)。
关键词
紧急宫颈环扎术
延长孕周
影响因素
Emergency cervical cerclage
Prolongation of gestation
Influencing factors
