Comparison of pregnancy outcomes after transvaginal cervical cerclage for different surgical indications during pregnancy
- Author:
Mao-huai WANG
1
;
Feng-di LAI
1
;
Xiao-qin XU
1
;
Xiao-ying XIE
1
Author Information
- Publication Type:Journal Article
- Keywords: cervical insufficiency; surgical indications; cervical cerclage; pregnancy outcome
- From: Chinese Journal of Practical Gynecology and Obstetrics 2019;35(09):1027-1030
- CountryChina
- Language:Chinese
- Abstract: OBJECTIVE: To retrospectively analyze and compare the clinical effects of transvaginal cervical cerclage during pregnancy with different surgical indications.METHODS: A total of 39 patients who underwent transvaginal cervical cerclage during pregnancy in the Gynaecology and Obstetrics Department of the First Affiliated Hospital of Gannan Medical University from July 2012 to June 2018 were enrolled.The patients were grouped according to the indications of surgery:those with the history of late abortion or preterm labor being the indication of surgery were the indication of the history of the cerclage group（group H,20）,and those with the length of the cervix being shortened or the shape of the cervix being changed in vaginal ultrasound indication cerclage group（group U,20）.The patients whose hysical examination revealed dilated cervix with or without amniocentesis were included as emergency cerclage group（group E,7）.The clinical effects of vaginal cervical cerclage during pregnancy were compared among the 3 groups.RESULTS: The gestational week of cerclage in the H group[（15.64 ± 2.96）w] was shorter than that in the U group[（22.04±5.01）w]and the E group[（22.08±2.96）w],and the difference was statistically significant（P<0.05）,but the gestational age of cerclage was of no significant difference between the E group and the U group（P>0.05）.The extended days[（29.43±47.24）d],gestational age of delivery[（26.39±6.52）w],full-term birth rate（14.29%）and live birth rate（28.57%）in group E were all lower than those in group H[（136.45±53.70）d,（35.60±7.07）w,69.57%,86.36%]and group U[（103.40±36.15）d,（36.81±3.45）w,70.00%,100.00% ],with statistically significant differences（P<0.05）.No statistically significant differences were observed between group H and group U（P>0.05）.The abortion rate（71.42%）in group E was higher than that in group H（13.04%）and group U（00.00%）（P<0.05）,but there was no statistically significant difference between group H and group U（P>0.05）.There was no significant difference in preterm birth rate among the three groups（P>0.05）.CONCLUSION: Cervical cerclage with three different surgical indications can effectively improve the pregnancy outcome of patients with cervical insufficiency.The pregnancy outcomes are similar between the indication of the history of the cerclage and the vaginal ultrasound indication cerclage,but better than the emergency cerclage.
