宫颈机能不全患者孕期治疗对妊娠结果的影响

目的 探讨宫颈机能不全患者孕期治疗前后的临床效果及对妊娠结果的影响.方法 回顾性分析2010年3月至2014年10月因宫颈机能不全收治本院的患者,分析于不同孕期、不同治疗时机行宫颈环扎术对妊娠结果的影响.结果 妊娠早期组行宫颈环扎术66例与妊娠中期组行宫颈环扎术53例相比较,两组晚期流产率、足月生产率、宫内感染率差异均具有统计学意义(P＜0.05).紧急治疗组41例与非紧急治疗组78例对比,两组晚期流产率、足月生产率、宫内感染率相比较,差异均具有统计学意义(P＜0.05).结论 宫颈机能不全患者应于妊娠14～16周择期行宫颈环扎术治疗;对于孕前宫颈机能不全诊断不明患者,伴早产史或晚期流产史的高危孕妇,在孕中期通过B型超声发现宫颈机能不全,应行紧急宫颈环扎术治疗,术后加强监测,预防感染,从而降低宫内感染率及晚期流产率,提高胎儿足月生产机会,最终达到改善妊娠结局的目的.

Impact of treatment for cervical insufficiency during pregnancy on pregnant outcomes

Objective To analyze the impact of treatment for cervical insufficiency during pregnancy on pregnant outcomes.Methods 119 patients undergoing cervical cerclage for cervical insufficiency from March,2010 to October,2014 were retrospectively analyzed.The impact of cervical cerclage at different pregnant periods and timings on pregnant outcomes was analyzed.Results The early pregnancy group (66 cases) were compared with the second trimester group (53 cases);there were statistical differences in late abortion rate,mature delivery rate,and intrauterine infection rate between these two groups (P＜0.05).The urgent treatment group(41 cases) was compared with the un-urgent treatment group(78 cases);there were statistical differences in late abortion rate,mature delivery rate,and intrauterine infection rate between these two groups (P＜0.05).Conclusions Cervical cerclage should be carried out in patients with cervical insufficiency when they are 14-16 weeks pregnant;patients can not be surely diagnosed with cervical insufficiency before pregnancy,high risk puerperae having premature delivery or late abortion history,and patients found with cervical insufficiency during middle pregnancy by ultrasound should receive urgent cervical cerclage and infection prevention and be monitored after surgery so as to decrease intrauterine infection rate and late abortion rate and improve pregnant outcomes.