双胎妊娠紧急宫颈环扎术一例并文献复习  

Emergency Cervical Cerclage in Twin Pregnancies:A Case Report and Literature Review

作　　者：陈佳[1,3] 李映桃 钟彩娟[1,3] 梁黎璇 黄颖敏 王艳 曾丽珠 CHEN Jia;LI Ying-tao;ZHONG Cai-juan;LIANG Li-xuan;HUANG Ying-min;WANG Yan;ZENG Li-zhu(Department of Obstetrics,The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China;Department of Ultrasound,The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China;Guangzhou Medical Centre for Critical Pregnant Women,Key Laboratory for Major Obstetric Disease of Guangdong Province,Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院产科,510150 [2]广州医科大学附属第三医院超声科,510150 [3]广东省产科重大疾病重点实验室

出　　处：《国际妇产科学杂志》2020年第4期408-412,I0001,共6页Journal of International Obstetrics and Gynecology

基　　金：广东省2017年适宜技术推广项目(粤卫通〔2017〕8号);广州市2020年高校创新创业(就业)教育项目(穗教高教〔2019〕15号)。

摘　　要：早产是围生儿死亡的主要原因。双胎妊娠早产发生率高,宫颈机能不全(cervical incompetence,CIC)是其原因之一。目前全球尚无指南推荐的方法预测双胎CIC,其诊断也主要基于病史和体格检查结果,经超声预测和诊断困难,且治疗方法和效果评价也存在争议。现报道1例双胎妊娠在孕22+4周,无宫缩,宫颈扩张4 cm,排除感染后,经阴道以W6977缝线行双重紧急环扎,延长孕周50 d,分娩2活婴,介绍其临床诊治过程,并复习近年国内外双胎妊娠CIC紧急环扎治疗进展的相关文献。Preterm birth is the leading cause of perinatal mortality.The incidence of preterm birth in twin pregnancies is high,and one of the reasons is cervical incompetence(CIC).Now there are no guidelines recommended in the world to predict CIC in twin pregnancies.The diagnosis is also based on medical history and physical examination.Prediction and diagnosis by ultrasound are difficult.The treatment methods and evaluation of effects are also controversial.We report a case for twin pregnancies which undergo emergency cervical cerclage with suture W6977 at 22+4 weeks gestation with the cervix dilated by 4 cm and infection is ruled out.The time from cerclage placement to delivery were 50 days with 2 live babies were born.The current research of the diagnosis and treatment for CIC in twin pregnancies is reviewed.

关 键 词：妊娠 双胎 宫颈功能不全 环扎术 宫颈 缝线 围生期医护 病例报告 

分 类 号：R719[医药卫生—妇产科学]