目的观察宫颈环扎手术治疗中期妊娠宫颈机能不全的临床效果。方法回顾性分析2012年1月~2018年3月48例中期妊娠诊断为宫颈机能不全行宫颈环扎术的临床资料,观察患者术后情况[术后保胎时间、术后并发症(1周内阴道出血、胎膜早破、感染)]...目的观察宫颈环扎手术治疗中期妊娠宫颈机能不全的临床效果。方法回顾性分析2012年1月~2018年3月48例中期妊娠诊断为宫颈机能不全行宫颈环扎术的临床资料,观察患者术后情况[术后保胎时间、术后并发症(1周内阴道出血、胎膜早破、感染)]、妊娠结局(活产率、延长妊娠孕周、分娩孕周)及新生儿预后(出生体重及Apgar评分)。结果术后保胎时间(8.2±5.7)d。术后1周内阴道出血率33.3%(16/48)、胎膜早破率14.6%(7/48),感染率10.4%(5/48)。≥37孕周分娩22例,28~37孕周16例,<28孕周难免流产10例。围生儿存活率为86.8%(33/38),33例新生儿1 min Apgar评分7~10分,出生体重(2415±207)g,低出生体质量儿5例。结论对中期妊娠出现宫颈功能不全行宫颈环扎术可以有效改善患者的妊娠结局,根据患者自身情况个体化选择手术方式才能达到最佳疗效。展开更多
目的观察妊娠期宫颈机能不全患者行腹腔镜下宫颈环扎术对妊娠结局的影响。方法中孕期宫颈机能不全36例患者行腹腔镜下宫颈环扎术,分析术后宫颈管长度的变化、妊娠延长时间以及妊娠结局。结果与术前相比,行宫颈环扎术后宫颈管长度增加[(3...目的观察妊娠期宫颈机能不全患者行腹腔镜下宫颈环扎术对妊娠结局的影响。方法中孕期宫颈机能不全36例患者行腹腔镜下宫颈环扎术,分析术后宫颈管长度的变化、妊娠延长时间以及妊娠结局。结果与术前相比,行宫颈环扎术后宫颈管长度增加[(3.15±0.29) cm vs.(1.95±0.33) cm](P<0.01)。环扎后分娩孕周长于以前最大流产孕周[(255.58±8.58) d vs.(137.25±1.23) d](P<0.01)。36例患者均选择剖宫产,新生儿体重为(3080±230) g,1分钟Apgar评分为(8.23±0.63)分。结论妊娠期宫颈机能不全患者行腹腔镜下宫颈环扎术能够有效改善妊娠结局,并不影响胎儿的正常发育。展开更多
Background:Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality worldwide,and its prevention is an important health-care priority.The cervical incompetence is a well-known risk factor for P...Background:Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality worldwide,and its prevention is an important health-care priority.The cervical incompetence is a well-known risk factor for PTB and its incidence is about 0.1-2.0%,while there is no ideal optimum treatment recommended currently.The cervical incompetence causes about 15% of habitual abortion in 16-28 weeks.This study aimed to evaluate the effectiveness and safety of cervical cerclage and vaginal progesterone in the treatment of cervical incompetence with/without PTB history.Methods:We retrospectively observed the pregnancy outcome of 198 patients diagnosed with cervical incompetence from January 2010 to October 2015 in Beijing Hospital.Among the 198 women involved,women who had at least one PTB before 32 weeks (including abortion in the second trimester attributed to the cervical competence) were assigned to the PTB history cohort,and others were assigned to the non-PTB history cohort.All women underwent cerclage placement (cervical cerclage group) or administrated with vaginal progesterone (vaginal progesterone group) until delivery.The outcomes of interest were the differences in gestational age at delivery,the rate of premature delivery,neonatal outcome,complications,and route of delivery between the two treatment groups.Results:Among the 198 patients with cervical incompetence,116 patients in PTB history cohort and 80 patients in non-PTB history cohort were included in the final analysis.In the PTB history cohort,cervical cerclage group had significantly longer cervical length at 2 weeks after the start of treatment (23.1 ± 4.6 mm vs.12.4 ± 9.1 mm,P =0.002),higher proportion of delivery ≥37 weeks' gestation (63.4% vs.33.3%,P =0.008),bigger median birth weight (2860 g vs.2250 g,P =0.031),and lower proportion of neonates whose 1-min Apgar score 〈7 (5.9% vs.33.3%,P =0.005),compared with vaginal progesterone group.No significant differences were found in other outcome measures betw展开更多
文摘目的观察宫颈环扎手术治疗中期妊娠宫颈机能不全的临床效果。方法回顾性分析2012年1月~2018年3月48例中期妊娠诊断为宫颈机能不全行宫颈环扎术的临床资料,观察患者术后情况[术后保胎时间、术后并发症(1周内阴道出血、胎膜早破、感染)]、妊娠结局(活产率、延长妊娠孕周、分娩孕周)及新生儿预后(出生体重及Apgar评分)。结果术后保胎时间(8.2±5.7)d。术后1周内阴道出血率33.3%(16/48)、胎膜早破率14.6%(7/48),感染率10.4%(5/48)。≥37孕周分娩22例,28~37孕周16例,<28孕周难免流产10例。围生儿存活率为86.8%(33/38),33例新生儿1 min Apgar评分7~10分,出生体重(2415±207)g,低出生体质量儿5例。结论对中期妊娠出现宫颈功能不全行宫颈环扎术可以有效改善患者的妊娠结局,根据患者自身情况个体化选择手术方式才能达到最佳疗效。
文摘目的观察妊娠期宫颈机能不全患者行腹腔镜下宫颈环扎术对妊娠结局的影响。方法中孕期宫颈机能不全36例患者行腹腔镜下宫颈环扎术,分析术后宫颈管长度的变化、妊娠延长时间以及妊娠结局。结果与术前相比,行宫颈环扎术后宫颈管长度增加[(3.15±0.29) cm vs.(1.95±0.33) cm](P<0.01)。环扎后分娩孕周长于以前最大流产孕周[(255.58±8.58) d vs.(137.25±1.23) d](P<0.01)。36例患者均选择剖宫产,新生儿体重为(3080±230) g,1分钟Apgar评分为(8.23±0.63)分。结论妊娠期宫颈机能不全患者行腹腔镜下宫颈环扎术能够有效改善妊娠结局,并不影响胎儿的正常发育。
文摘Background:Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality worldwide,and its prevention is an important health-care priority.The cervical incompetence is a well-known risk factor for PTB and its incidence is about 0.1-2.0%,while there is no ideal optimum treatment recommended currently.The cervical incompetence causes about 15% of habitual abortion in 16-28 weeks.This study aimed to evaluate the effectiveness and safety of cervical cerclage and vaginal progesterone in the treatment of cervical incompetence with/without PTB history.Methods:We retrospectively observed the pregnancy outcome of 198 patients diagnosed with cervical incompetence from January 2010 to October 2015 in Beijing Hospital.Among the 198 women involved,women who had at least one PTB before 32 weeks (including abortion in the second trimester attributed to the cervical competence) were assigned to the PTB history cohort,and others were assigned to the non-PTB history cohort.All women underwent cerclage placement (cervical cerclage group) or administrated with vaginal progesterone (vaginal progesterone group) until delivery.The outcomes of interest were the differences in gestational age at delivery,the rate of premature delivery,neonatal outcome,complications,and route of delivery between the two treatment groups.Results:Among the 198 patients with cervical incompetence,116 patients in PTB history cohort and 80 patients in non-PTB history cohort were included in the final analysis.In the PTB history cohort,cervical cerclage group had significantly longer cervical length at 2 weeks after the start of treatment (23.1 ± 4.6 mm vs.12.4 ± 9.1 mm,P =0.002),higher proportion of delivery ≥37 weeks' gestation (63.4% vs.33.3%,P =0.008),bigger median birth weight (2860 g vs.2250 g,P =0.031),and lower proportion of neonates whose 1-min Apgar score 〈7 (5.9% vs.33.3%,P =0.005),compared with vaginal progesterone group.No significant differences were found in other outcome measures betw