不同妊娠期经阴道子宫颈环扎术后妊娠结局分析

Analysis of pregnancy outcome of different transvaginal cervical cerclage

Objective?To investigate the differences in pregnancy outcomes between the different transvaginal cervical cerclage. Methods?This retrospective study included pregnant women with cervical insufficiency admitted to Peking University People’s Hospital between January 2013 and September 2021. There were 37 patients in the study group underwent Shirodkar’s cerclage, and 32 patients in the control group underwent McDonald’s cerclage. The pregnancy outcomes were compared. Results?Compared with the control group, the study group showed more weight gain during pregnancy(12.66±6.00) kg/m2, (9.21±5.79) kg/m2; P=0.022], long operation time 45 min(40-51.3 min) vs. 20.5 min (17.3-25.0), P<0.001] and later cerclage removal 36.71(36.14-37) vs. 34.43(24.32-36.75), P=0.003]. Gestational weeks at delivery in the Shirodkar group were more advanced than in the McDonald group38.9 (36.3-39.8) vs.35.0 (30.1-39.0), P=0.005]. Compared with the McDonald group, the Shirodkar group had higher incidences of deliveries≥28 gestational weeks (91.9% vs. 68.8%, P=0.027), deliveries≥34 gestational weeks (81.1% vs. 59.4%, P=0.037), deliveries≥37 gestational weeks (67.6% vs. 37.5%, P<0.001), induced labor (43.2% vs. 12.5%, P=0.006), and fewer fetal loss (8.1% vs. 31.3%, P=0.017). Multivariate regression analysis of preterm birth factors showed that Shirodkar cervical cerclage was a protective factor to reduce the incidence of preterm birth(OR=0.063, 95%CI: 0.008, 0.492, P=0.008). Conclusion?Shirodkar cerclage appears to have advantages over McDonald cerclage in preventing fetal loss and a fewer frequency of preterm deliveries.