Objective To analyze the pregnancy outcome of laparoscopy cervical cerclage before pregnancy in treatment of uterine cervical insufficiency. Methods The clinical data of 78 uterine cervical incompetence patients having underwent cervical cerclage before pregnancy were retrospectively analyzed. Among them 40 cases underwent laparoscopy cervical cerclage (laparoscopy group), and 38 cases underwent transvaginal cervical cerclage (transvaginal group). The operation time, complications, length of cervix in pregnancy, lengthen time of gestational weeks, gestational weeks, perinatal infant weight, survival rate of perinatal infants and infection rate of uterine cavity were compared between 2 groups. Results The length of cervix in pregnancy, lengthened time of gestational weeks, perinatal infant weight, term labor rate and survival rate of perinatal infants in laparoscopy group were significantly higher than those in transvaginal group: (4.35 ± 0.52) cm vs. (3.51 ± 0.66) cm, (116.7 ± 9.8) d vs. (90.2 ± 5.2) d, (3 050 ± 759) g vs. (2 500 ± 431) g, 60.0%(24/40) vs. 31.6%(12/38) and 95.0%(38/40) vs. 78.9%(30/38), and the infection rate of uterine cavity was significantly lower than that in transvaginal group: 2.5% (1/40) vs. 18.4% (7/38), and there were statistical differences (P<0.05). There were no statistical differences in operation time and incidence of complications (P > 0.05). Conclusions Laparoscopy cervical cerclage before pregnancy in treatment of uterine cervical incompetence can effectively maintain the cervical length period of pregnancy, improve the success rate of surgery, prolong gestational weeks, and improve perinatal outcome.

Objective To study the pre- pregnancy cervical cerclage method in the different cervical length of uterine cervical incompetence patients. Methods The clinical data of 128 uterine cervical incompetence patients having underwent pre-pregnancy cervical cerclage were retrospectively analyzed. The preoperative cervical length was measured by transvaginal ultrasound. Cervical length >2.5 cm was in 60 cases, of which 34 cases underwent laparoscopic cervical cerclage, and 26 cases underwent transvaginal cervical cerclage; cervical length ≤ 2.5 cm was in 68 cases, of which 32 cases underwent laparoscopic cervical cerclage, and 36 cases underwent transvaginal cervical cerclage. Results For the patients with preoperative cervical length > 2.5 cm, there were no statistical differences in the postoperative pregnancy cervical length, gestational weeks time, perinatal birth weight, perinatal survival rate, gestational age of delivery and intrauterine infection rate between 2 methods (P>0.05). For the patients with preoperative cervical length ≤ 2.5 cm, the postoperative pregnancy cervical length, gestational weeks time, perinatal birth weight, perinatal survival rate and gestational age of delivery in laparoscopic cervical cerclage patients were significantly higher than those in transvaginal cervical cerclage patients: (3.85 ± 0.37) cm vs. (3.16 ± 0.49) cm, (101.75 ± 4.71) d vs. (80.62 ± 3.53) d, (2850 ± 323) g vs. (2330 ± 585) g, 90.6% (29/32) vs. 69.4% (25/36) and 50.0% (16/32) vs. 22.2%(8/36), but the intrauterine infection rate was significantly lower than that in transvaginal cervical cerclage patients:0 vs. 16.7%( 6/36), and there were statistical differences (P<0.05). All patients had no obvious complications. Conclusions For cervical length > 2.5 cm patients with uterine cervical incompetence, pre- pregnancy cervical cerclage can choose transvaginal or laparoscopic. But for patients with the cervical length≤2.5 cm or previous cervical cerclage failure, laparoscopic cervical cerclage is better than transvaginal cervical cerclage.

Objective To evaluate the clinical effect of cervical cerclage in the treatment of pregnant with uterine cervical incompetence.Methods The clinical and follow -up data of 25 pregnant women with uterine cervi-cal incompetence who taken cervical cerclage were retrospectively analyzed.Results In 25 pregnant women with uterine cervical incompetence,there were 22 cases of neonatal survival,3 cases of abortion,surgical success rate was 88.0%.Conclusion Cervical cerclage is effective in the treatment of pregnant women with uterine cervical incompe-tence,and the timing of surgery should choose 14 -18 weeks gestation.

Objective To observe the pregnancy by transvaginal double slit cervical pregnancy outcome after ligation,and evaluate its clinical application value.Methods The clinical data of 80 cases with cervical incompe-tence were analyzed.All patients had pregnant metaphase inevitable abortion history,the average abortion pregnant was 21.7 week.According to different treatment methods,80 cases were divided into two groups,treatment group (40 cases)in non pregnant women with silk thread woven tape by double vagina and cervix cerclage,another group of 40 cases in 15 -20 weeks of pregnancy by using polypropylene McDonald method with cerclage.The operation,preg-nancy cervical tube length and pregnancy outcome were observed.Results The average operation time and bleeding volume between the two groups had no statistically significant differences.The pregnancy cervical average length of the treatment group was 4.6(4.8 ±0.5)cm,which was significantly longer than 3.9(3.1 ±0.8)cm of the control group (t =2.732,P <0.05).In the treatment group,the full -term delivery rate,preterm delivery rate,mean gestational age at delivery were 55.0%(22 /40),40.0%(16 /40),35.8 weeks,the average abortion was extended 14.1 weeks com-pared with preoperation,fetal survival rate was 90.0%(36 /40),neonatal birth weight was (3 100.0 ±200.0)g;28 gestational weeks following the inevitable abortion rate was 2.5%(1 /40).In the control group,the term delivery rate was 35.0%(14 /40),the rate of premature birth was 50.0%(20 /40),and the rate of abortion was 15.0%(6 /40)in 28 weeks.Mean gestational age at delivery was 33.2 weeks,which was extended 11.5 weeks compared with preoperative average abortion,fetal survival rate was 85.0% (34 /40),neonatal body mass was (2 900.0 ±300.0)g. The term delivery rate,fetal survival rate and neonatal weight in the treatment group were higher than those in the con-trol group.Conclusion Pregnant by double vagina and cervix cerclage treatment cervical function can maintain preg-nancy,cervical length,prolong the time of pregnancy and improve the perinatal survival rate,simple operation,take out stitches convenient,it is worthy of clinical application.

Objective To observe the effect of pregnancy double loop cerclage for cervical incompetence. Methods 80 cases of cervical function incompetence according to the type of surgery were divided into two groups, 40 cases in each group,15 -20 weeks of surgery in pregnancy,the treatment group underwent double loop cerclage, the control group underwent McDonald single cerclage.The operation,postoperative cervical length and pregnancy outcome of the two groups were observed.Results There was no difference in operation time and blood loss between the two groups.The length of cervix in the treatment group was (4.63 ±0.52)cm,which was longer than (3.71 ± 0.82)cm of the control group(t =2.106,P <0.05).Pregnancy outcome:20 cases of the treatment group in term birth (50%),preterm birth in 18 cases (45%)(34 -37 weeks in 12 cases,28 -34 weeks in 6 cases),fetal survival in 36 cases (90%),less than 28 weeks pregnant inevitable abortion in 2 cases (5%),abortion did not survive.Average delivery gestational age was 35.2 weeks,and preoperative average abortion pregnant weeks contrast,treatment group delivery gestational weeks extended 13.5 weeks,the average weight of newborns was (3 200 ±200)g.The control group of full -term delivery was 14 cases (35%),premature in 20 cases (50%)(34 -37 weeks in 7 cases and 13 cases of 28 -34 weeks),fetal survival in 33 cases (82.5%),less than 28 weeks pregnant inevitable abortion in 4 cases (10%),abortion did not survive.Average delivery gestational age was 33.2 weeks,compared with the average abortion weeks before operation,the gestational age of the control group was extended by 11.5 weeks.The weight of newborn was (2 900 ±300)g.In the treatment group,the term labor rate,fetal survival rate,neonatal weight were higher than those of the control group,the difference was statistically significant (χ2 =7.83,P <0.05).Conclusion The second trimester cervical double cerclage can maintain effective cervical length,prolong gestational age,improve perinatal survival rate.

Objective To analyze the pregnancy outcome of laparoscopic cervical cerclage before pregnancy, discuss the clinical value of the treatment of cervical incompetence.Methods 40 cases with cervical insufficiency during 2012.1 -2016.3 before pregnancy underwent laparoscopic ligation.All patients had a history of abortion or premature birth,and the average gestational age was 23.7 weeks.Preoperative cervical length was less than 2.5cm. The operation condition and the pregnancy outcome after operation were observed.Results The average time of oper-ation was 35.6(40.2 ±10.4)min and the amount of bleeding was 10.3(15.7 ±3.2)mL.Postoperative pregnancy cervical average length was 3.61 (4.35 ±0.52)cm.Pregnancy outcome:37 weeks of gestation and above delivery 20 cases (50.0%).34 -37 weeks 16 cases (40.0%),28 -34 weeks in 3 cases,received cesarean section,the aver-age gestational was 35.6 weeks.Compared with the preoperative abortion,the gestational week of delivery was pro-longed by 12.1 weeks.Neonatal survival in 38 cases (95.0%),1 case of gestational 28 +3 weeks premature death. Neonatal birth weight was 2 800(3 079 ±500)g;1 case (2.5%)was difficult to avoid abortion at 23 weeks of gesta-tion.Conclusion Laparoscopic pre -pregnancy cervical cerclage suture in cervix mouth,postoperative can maintain effective cervical length,prolong gestational age,improve the pregnancy outcome,can be used as effective treatment for the pregnant cerclage failure or cervical length less than 2.5cm of cervical insufficiency patients.

Objective To investigate pregnancy outcome and feasibility of early pregnancy laparoscopic cervical cerclage surgery in patients with uterine cervical incompetence. Methods The clinical data of 24 uterine cervical incompetence patients who had underwent early pregnancy laparoscopic cervical cerclage were retrospectively analyzed, and the operation and pregnancy outcomes were observed. Results The anesthesia and operation of all patients were smooth, and no abortion occurred during and after operation. The operation time was (40.3 ± 5.8) min, and the amount of bleeding was (32.9 ± 4.3) ml. The cervical length of pregnancy was (3.5 ± 0.8) cm. All patients were cesarean delivery, and the gestational age of delivery was (34.8 ± 2.6) weeks. The term delivery rate was 50.0% (12/24); the perineonate survival rate was 95.8% (23/24), and none of the neonates had birth defects. The weight of 23 neonates was (2 735 ± 528) g, and the low birth weight infant was in 4 cases. Conclusions For those who need to progestation cervical cerclage but failed to timely surgery or whose cervical length less than 2.5 cm in patients with early pregnancy uterine cervical incompetence, early pregnancy laparoscopic cervical cerclage is safe and feasible. After the operation, the gestational age can be prolonged, the perineonate survival rate will be improved, and the pregnancy outcome will be improved.

In order to better control the quality of Flos Puerariae(FP),qualitative and quantitative analyses were initially performed by using chemical fingerprint and chemometrics methods in this study.First,the fingerprint of FP was developed by HPLC and the chemical markers were screened out by similarity analysis(SA),hierarchical clustering analysis(HCA),principal components analysis(PCA),and orthogonal partial least squares discriminant analysis(OPLS-DA).Next,the chemical constituents in FP were profiled and identified by HPLC coupled to Fourier transform ion cyclotron resonance mass spectrometry(HPLC-FT-ICR MS).Then,the characteristic constituents in FP were quantitatively analyzed by HPLC.As a result,31 common peaks were assigned in the fingerprint and 6 of them were considered as qualitative markers.A total of 35 chemical constituents were detected by HPLC-FT-ICR MS and 16 of them were unambiguously identified by comparing retention time,UV absorption wavelength,accurate mass,and MS/MS data with those of reference standards.Subsequently,the contents of glycitin,genistin,tectoridin,glycitein,genistein,and tectorigenin in 13 batches of FP were detected,ranging from 0.4438 to 11.06 mg/g,0.955 to 1.726 mg/g,9.81 to 57.22 mg/g,3.349 to 41.60 mg/g,0.3576 to 0.989 mg/g,and 2.126 to 9.99 mg/g,respectively.In conclusion,fingerprint analysis in combination with chemometrics methods could discover chemical markers for improving the quality control standard of FP.It is expected that the strategy applied in this study will be valuable for further quality control of other traditional Chinese medicines.