腹腔镜下子宫颈环扎术治疗不同孕周及不同妊娠类型孕产妇子宫颈机能不全妊娠结局分析  

Analysis of clinical pregnancy outcomes of laparoscopic cervical cerclage in pregnant women with cervical insufficiency at different gestational weeks and with different types of pregnancy

作　　者：曹静 梁升连[2] 徐亚雄 应小燕 CAO Jing;LIANG Sheng-lian;XU Ya-xiong;YING Xiao-yan(Department of Obstetrics and Gynecology,Sir Run Run Hospital,Nanjing Medical University,Nangjing 211112,China)

机构地区：[1]南京医科大学附属逸夫医院妇产科,江苏南京211112 [2]南京医科大学第二附属医院妇产科,江苏南京210003

出　　处：《中国实用妇科与产科杂志》2024年第11期1135-1137,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：江苏省自然科学基金(BK20220736)。

摘　　要：目的 探讨腹腔镜下子宫颈环扎术治疗不同孕周、不同妊娠类型子宫颈机能不全孕产妇的临床妊娠结局。方法 选取2018年6月至2022年1月南京医科大学第二附属医院妇科收治的腹腔镜下行子宫颈环扎术的子宫颈机能不全孕产妇76例,根据孕周分为≤14孕周33例,孕14^(+1)~20周43例;根据妊娠类型分为单胎59例,双胎17例。观察比较不同孕周及妊娠类型孕产妇的临床资料、分娩方式、新生儿结局;单胎、双胎妊娠子宫颈环扎术干预后的妊娠结局。结果 不同孕周子宫颈环扎孕产妇的临床资料(年龄、手术时间、术中出血量等)、妊娠结局(足月产率、早产率、流产率、活产率)差异均无统计学意义(P>0.05);单胎妊娠足月产率高于双胎妊娠(62.7%vs. 29.4%,χ^(2)=5.919,P=0.015),早产率低于双胎妊娠(28.8%vs. 64.7%,χ^(2)=7.307,P=0.007),两组的流产率差异无统计学意义(P=1.000)。结论 腹腔镜下子宫颈环扎术对不同孕周、不同妊娠类型的子宫颈机能不全的孕产妇是安全可行的。Objective To explore the clinical pregnancy outcome of pregnant women with cervical insufficiency at different gestational weeks and with different types of pregnancy by laparoscopic cervical cerclage.Methods A total of 76 pregnant women with cervical insufficiency who underwent laparoscopic cervical cerclage in the Department of Gynecology of the Second Affiliated Hospital of Nanjing Medical University from June 2018 to January 2022 were selected,and they were divided into two groups:33 cases in the group≤14 weeks and 43 cases in the group 14^(+1)~20 weeks of gestation.The types of pregnancy included 59 singleton pregnancies and 17 twin pregnancies.The clinical data of pregnant women receiving cervical cerclage,delivery outcomes and neonatal outcomes of the two groups were observed and compared.Pregnancy outcomes after cervical cerclage intervention in singleton and twin pregnancies were also observed and compared.Results There were no significant differences in clinical data(age,operation time,intraoperative blood loss,etc.)and pregnancy outcomes(full-term birth rate,preterm birth rate,miscarriage rate,and live birth rate)among pregnant women with dfferent gestational weeks(P>0.05).The full-term birth rate of singleton pregnancy was higher than that of twin pregnancy(62.7%vs.29.4%,χ^(2)=5.919,P=0.015),while the preterm birth rate was lower than that of twin pregnancy(28.8%vs.64.7%,χ^(2)=7.307,P=0.007),and there was no significant diference in miscarriage rate between the two groups(P=1.000).Conclusion Laparoscopic cervical cerclage is safe and feasible for pregnant women with cervical insufficiency at different gestational weeks and with different types of pregnancy.

关 键 词：腹腔镜子宫颈环扎术 子宫颈机能不全 孕周 

分 类 号：R713.4[医药卫生—妇产科学]