Analysis of pregnancy outcome of different cervical cerclage in the treatment of cervical insufficiency
Journal Title: Journal of Air Force Medical University - Year 2023, Vol 44, Issue 6
Abstract
Objective To study the clinical effect of different cervical cerclage on patients with cervical insufficiency (CI). Methods The clinical data of 527 patients diagnosed with CI and treated with different cervical cerclage in the Department of Obstetrics and Gynecology, Xijing Hospital, Air Force Medical University from April 2009 to February 2022 were analyzed. There were 378 cases of transvaginal prophylactic cervical cerclage, 71 cases of transvaginal emergency cervical cerclage, 65 cases of laparoscopic cervical cerclage, 10 cases of robot-assisted laparoscopic cervical cerclage, and 3 cases of transvaginal pessary placement. The pregnancy outcomes were analyzed, respectively. Results The pregnancy success rate of transvaginal prophylactic cervical cerclage was 95. 2% , only 56. 3% transvaginal emergency cervical cerclage was succeed, and the success rate of laparoscopic cervical cerclage was 98. 5% . Age and times of pregnancy and childbirth had no effect on the choice of cervical cerclage. The length of cervical canal, prolonged gestational week, neonatal body mass and gestational week of delivery in the transvaginal prophylactic cervical cerclage group were higher than those in the transvaginal emergency cervical cerclage group ( P < 0. 05 ). The body mass and gestational weeks of newborns in the laparoscopic cervical cerclage group were higher than those in the transvaginal emergency cerclage group (P < 0. 05), and there was no significant difference in the length of cervical canal ( P > 0. 05 ). The length of cervical canal in the transvaginal prophylactic cervical cerclage group was longer than that in the laparoscopic cervical cerclage group (P < 0. 05). The gestational weeks of delivery in the transvaginal prophylactic cervical cerclage group were greater than those in the laparoscopic cervical cerclage group (P < 0. 05). There was no significant difference in neonatal body mass (P > 0. 05). The success rate of pregnancy of transvaginal prophylactic cervical cerclage was 95. 2% , the success rate of pregnancy of transvaginal emergency cervical cerclage was 56. 3% , and the success rate of pregnancy of laparoscopic cervical cerclage was 98. 5%. The sample size of the robot-assisted laparoscopic cervical cerclage group and the transvaginal pessary placement group was too small, and the random error was large, so the conclusions drawn were not representative. Conclusion Cervical cerclage is the safest and the most effective surgical method for the treatment of CI. The success rate of transvaginal prophylactic cervical cerclage is high, and there is no significant difference between laparoscopic cervical cerclage and transvaginal prophylactic cervical cerclage. The sample size of the transvaginal pessary placement group needs to be increased to further verify this result in the treatment of CI.
Authors and Affiliations
LIANG Jia, YAO Nianling, WANG Shanshan, QIAO Guyuan, BAI Lu, MA Yihu, MA Yan, ZHANG Junru, MA Xiangdong
Keywords
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