摘要
【目的】分析非孕期腹腔镜宫颈环扎术与孕期腹腔镜宫颈环扎术治疗宫颈机能不全的妊娠结局。【方法】回顾性分析中山大学附属第一医院2018年1月至2018年12月行腹腔镜宫颈环扎术患者225例,其中非孕期患者138例(非孕期组)和孕期患者87例(孕期组)的临床资料,随访并收集患者的妊娠情况,比较非孕期组和孕期组的妊娠并发症发病率和妊娠结局,进一步多因素logistic回归分析非孕期和孕期腹腔镜宫颈环扎术对早产的影响。【结果】与孕期组相比,非孕期组患者早产率低(15.0%和27.6%,P=0.036),平均分娩孕周延长[(37.4±1.7)和(36.8±2.0)周,P=0.041],但妊娠中期胎儿丢失率高(15.9%和4.6%,P=0.010)。两组患者妊娠期并发症发病率、新生儿结局无统计学差异。多因素logistic回归分析发现孕期腹腔镜宫颈环扎术后早产的OR是非孕期宫颈环扎术患者的2.08倍,OR 95%CI为1.02~4.22,具有统计学差异(P=0.042)。【结论】非孕期腹腔镜宫颈环扎术可有效治疗宫颈机能不全,延长妊娠孕周,降低早产发生率,改善妊娠结局。
【Objective】To compare the maternal and neonatal outcomes of pre-and post-conceptional laparoscopic transabdominal cervical cerclage(LTCC)in women diagnosed with cervical insufficiency.【Methods】A retrospective study was done on 225 patients who underwent LTCC in the First Affiliated Hospital,Sun Yat-sen University between January 2018 and December 2018.138 women in the preconceptional group and the other 87 in the postconceptional group.Maternal and neonatal outcomes of these two groups were compared.Multivariable logistic regression analysis was performed to explore the impact of LTCC on preterm delivery.【Results】Compared with the postconceptional group,the preconceptional group showed a significantly decreased rate of preterm labor(15.0%vs.27.6%,P=0.036),a signifi⁃cantly prolonged gestational week at delivery[(37.4±1.7)wks vs.(36.8±2.0)wks,P=0.041]and a significantly increased second trimesters fetal loss rate(15.9%vs.4.6%,P=0.010).No significant difference was found in the risk of maternal complication and adverse neonatal outcomes between the two groups.Multivariable logistic regression analysis revealed that postconceptional LTCC correlated with premature labor(P=0.042),with 2.08 for odds ratio(OR)value and 1.02~4.22 for 95%CI.【Conclusion】LTCC,especially preconceptional LTCC,is more successful in improving obstetric outcomes by preventing preterm labor of patients with cervical insufficiency.
作者
祝彩霞
牛留长
欧阳玲珑
杨娟
牛刚
ZHU Cai-xia;NIU Liu-chang;OUYANG Ling-long;YANG Juan;NIU Gang(Department of Obstetrics&Gynecology,The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2020年第5期774-780,共7页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省自然科学基金(2017A030310191)。
关键词
宫颈机能不全
腹腔镜宫颈环扎术
非孕期
孕期
妊娠结局
cervical insufficiency
laparoscopic transabdominal cervical cerclage(LTCC)
preconceptional
post⁃conceptional
obstetric outcomes
