羊水减量联合紧急宫颈环扎术治疗中孕双胎妊娠无痛性宫口扩张的回顾性分析  

Amnioreduction Combined with Emergency Cervical Cerclage in the Treatment of Painless Cervical Dilation in Twin Pregnancy Women:a Retrospective Study

作　　者：付帅[1] 徐琦 吴琳祥 谭剑平[1] 祝丽琼[1] 刘颖琳[1] 陈慧[1,3] FU Shuai;XU Qi;WU Lin-xiang;TAN Jian-ping;ZHU Li-qiong;LIU Ying-lin;CHEN Hui(Department of Obstetrics and Gynecology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,China;Department of Obstetrics and Gynecology,The first Affiliated Hospital of Sun Yat-sen University,Guangzhou 510058,China;Department of Genetics and Cell Biology,Zhongshan School of Medicine,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学孙逸仙纪念医院妇产科,广东广州510120 [2]中山大学附属第一医院妇产科,广东广州510058 [3]中山大学中山医学院遗传学与细胞生物学教研室,广东广州510080

出　　处：《中山大学学报（医学科学版）》2021年第2期235-241,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81170625);广东省自然科学基金(2018A030313162)。

摘　　要：【目的】探讨羊水减量联合紧急宫颈环扎术治疗中孕双胎妊娠无痛性宫口扩张的安全性和有效性。【方法】将2013年1月1日至2019年7月31日于中山大学孙逸仙纪念医院住院,孕16~28周因无痛性宫颈外口扩张≥1 cm的双胎妊娠孕妇35例作为研究对象进行回顾性分析。所有孕妇行经腹羊膜腔穿刺羊水减量术后当日或次日行紧急宫颈环扎术,收集患者的妊娠情况及新生儿结局。【结果】35例孕妇行紧急宫颈环扎术前平均孕周(23.40±1.79)周,宫口扩张(3.90±2.80)cm,平均羊水减量(249.85±157.20)mL,无一例在术中发生胎膜破裂。自环扎至分娩平均时间间隔40.00(19.00~55.00)d,平均分娩孕周(29.43±3.98)周,新生儿存活率70%(49/70),抱婴回家率为74.29%(26/35),其中双胎均存活者占比65.71%(23/35),仅一胎存活者占比8.57%(3/35)。【结论】羊水减量术可安全应用于中孕无痛性宫口扩张的双胎妊娠孕妇,联合紧急宫颈环扎可延迟分娩孕周,对改善双胎妊娠结局具有一定的临床意义。【Objective】To investigate the safety and efficacy of amnioreduction combined with emergency cervical cer⁃clage in the treatment of painless cervical dilatation of twin pregnancy women in the second trimester.【Methods】Totally 35 cases of twin pregnancy women with painless cervical dilatation and cervical external orifice≥1 cm were included in our retrospective study from January 1,2013 to July 31,2019 in Sun Yat-sen University Memorial Hospital.All pregnant women were in 16 to 28 gestational weeks and treated with amnioreduction by abdominal amniocentesis,and then under⁃went emergency cervical cerclage.【Results】The average gestational age of 35 pregnant women were(23.40±1.79)weeks.The average size of cervical dilation was(3.90±2.80)cm before emergency cervical cerclage,and the average reduced volume of amniotic fluid was(249.85±157.20)mL.No membrane rupture occurred during the operation.The average interval from operation to delivery was 40.00(19.00~55.00)days,and the average gestational age of delivery was(29.43±3.98)weeks.Forty-nine newborns survived and 26 cases(74.29%,26/35)got at least one take-home baby,including 23 cases(65.71%,23/35)got two surviving newborns and 3 cases(8.57%,3/35)got only one surviving newborn.【Conclu⁃sions】Amnioreduction can be safely used in twin pregnancy women with painless cervical dilation in the second trimester.Amnioreduction combined with emergency cervical cerclage can delay the gestational age of delivery,which has certain clinical significance.

关 键 词：双胎妊娠 羊水减量术 紧急宫颈环扎 妊娠结局 新生儿结局 

分 类 号：R714.4[医药卫生—妇产科学]