多胎妊娠宫内治疗下的子宫颈环扎术取与舍  

Cervical cerclage for intrauterine treatment of multiple pregnancies

作　　者：郑东明[1] 刘彩霞[1] ZHENG Dong-ming;LIU Cai-xia(Department of Obstetrics and Gynecology,Research Center of China Medical University Birth Cohort,Key Laboratory of Maternal-Fetal Medicine of Liaoning Province,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院妇产科、中国医科大学出生队列中心、辽宁省母胎医学重点实验室,辽宁沈阳110004

出　　处：《中国实用妇科与产科杂志》2023年第8期791-794,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家重点研发计划(2018YFC1002902)。

摘　　要：随着辅助生殖技术的迅猛发展和孕产妇高龄化,多胎妊娠的发生率显著升高,其中,以双胎妊娠最为常见。多胎妊娠,包括双胎妊娠,可能会导致特有并发症的发生,如双胎输血综合征、双胎贫血-红细胞增多序列征、双胎反向动脉灌注序列征、选择性胎儿宫内生长受限、双胎之一染色体异常或发育异常等,有些需要孕期进行胎儿镜、减胎术等宫内治疗,增加了流产、早产风险。子宫颈环扎术可修复子宫颈口形态,给予子宫颈管支撑力,有效预防子宫颈口持续扩张,利于延长孕龄,维持妊娠。进行宫内治疗同时行子宫颈环扎术,能否降低流产、早产风险,目前研究的结论仍然存在争议。文章针对这一问题,结合国内外相关文献进行阐述。With the rapid development of assisted reproductive technology and the advanced maternal age,the incidence of multiple pregnancies has increased significantly,among which twin pregnancies are the most common.Multiple pregnancies,including twin pregnancies,may lead to unique complications,such as twin-twin transfusion syndrome,twin anemia polycythemia sequence,twin reversed arterial perfusion sequence,selective intrauterine growth restriction,chromosomal abnormalities or developmental abnormalities in one of the twins,etc.Some of them require intrauterine treatments such as fetoscopy and fetal reduction during pregnancy,which increases the risk of miscarriage and premature birth.Cervical cerclage can repair the morphology of the cervical ostiation,and give cervical canal support.Cervical cerclage also can prevent the continuous expansion of the cervical ostium effectively,and help prolong the gestational age and maintain pregnancy.It remains controversial whether intrauterine treatment with cervical cerclage can reduce the risk of miscarriage and preterm birth.This paper aims at this problem and makes a summary based on relevant literatures at home and abroad.

关 键 词：多胎妊娠 宫内治疗 胎儿镜手术 减胎术 子宫颈环扎术 

分 类 号：R711.74[医药卫生—妇产科学]