超声指征性宫颈环扎术对IVF-ET术后双胎妊娠患者妊娠结局的影响  

Effect of ultrasound-indicated cerclage of cervix on pregnancy outcomes of patients with twin pregnancies after IVF-ET

作　　者：徐路[1] 李德红 王佳佳[1] 凌秀凤[1] 寇青[1] 张蕾[1] XU Lu;LI Dehong;WANG Jiajia(Department of Obstetrics and Gynecology,Women's Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital),Nanjing 210004,CHINA)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)妇产科,江苏210004

出　　处：《江苏医药》2020年第6期597-600,共4页Jiangsu Medical Journal

基　　金：国家自然科学基金青年科学基金(81801404)。

摘　　要：目的观察超声指征性宫颈环扎术对体外受精-胚胎移植(IVF-ET)术后双胎妊娠患者妊娠结局的影响。方法回顾性分析85例经阴道超声提示宫颈长度<25 mm的IVF-ET术后双胎妊娠患者的临床资料;其中,42例行期待治疗(对照组),43例行经阴道宫颈环扎术(手术组)。比较两组患者一般资料、宫颈机能不全危险因素、妊娠结局和新生儿情况之间的差异。结果两组患者年龄、晚期流产史或早产史、绒毛膜性、诊断孕周、多囊卵巢综合征病史、宫腔操作次数、子宫畸形、晚期流产率及新生儿窒息率比较差异均无统计学意义(P>0.05)。与对照组相比,手术组患者延长孕周、分娩孕周、≥35周分娩率、新生儿出生体重增加(P<0.05),<35周早产率和围产儿死亡率降低(P<0.05)。结论对于阴道超声提示宫颈长度<25 mm的IVF-ET术后双胎妊娠患者,经阴道宫颈环扎术可有效延长孕周,改善妊娠结局。Objective To observe the effect of ultrasound-indicated cerclage of cervix on the pregnancy outcomes of the patients with twin pregnancies after in vitro fertilization and embryo transfer(IVF-ET).Methods The clinical data of 85 cases with twin pregnancies after IVF-ET were retrospectively analyzed,who were diagnosed with cervical length<25 mm by transvaginal ultrasound.The patients in group A(42 cases) were treated with bed-rest and symptomatic drug therapy,and those in group B(43 cases) were treated with transvaginal cervical cerclage.The basic informations,risk factors for cervical incompetence,pregnancy outcomes and newborn condition were compared between the two groups.Results There were no statistical differences in the age,history of late abortion or premature birth,chorionicity,diagnosis of gestational week,history of polycystic ovarian syndrome,time of intrauterine operation,uterine malformation,rate of late abortion and rate of neonatal asphyxia between the two groups(P>0.05).Compared with group A,the prolonged gestational weeks,delivery gestational age,rate of delivery over 35 weeks and newborn birth weight were increased(P<0.05),while the rates of premature delivery less than 35 weeks and perinatal mortality were decreased in group B(P<0.05).Conclusion For the patients with twin pregnancies after IVF-ET diagnosed with cervical length < 25 mm by transvaginal ultrasound,transvaginal cervical cerclage could significantly prolong the gestational week and improve the pregnancy outcomes.

关 键 词：宫颈机能不全 宫颈环扎术 双胎妊娠 体外受精-胚胎移植 

分 类 号：R713[医药卫生—妇产科学]