Clinical investigation of emergency cervical cerclage for uterine cervical incompetence patients in mid-trimester

doi:10.3877/cma.j.issn.1673-5250.2016.06.012

Objective

To analyze the clinical characteristics of emergency cervical cerclage(CC) for uterine cervical incompetence(UCI) patients in mid-trimester.

Methods

From January 2014 to October 2015, a total of 16 cases of UCI patients in mid-trimester who were underwent emergency CC in Liuzhou Maternity and Child Healthcare Hospital were chosen as study subjects. According to whether the neonatal survived or not, the 16 patients were divided into fetus nonsurvival group(n=6) and fetus survival group(n=10). Retrospectively analyzed the general clinical data and prolongation of pregnancy after CC of all subjects, and the birth weight and outcome of newborns, etc.. The age, the number of previous intrauterine operations, the degree of cervical dilatation, the gestational age at CC and at delivery, the prolongation of pregnancy after CC and the birth weight of the newborns were compared between two groups by statistical method. This study has been approved by the Ethics Committee of Liuzhou Maternal and Child Healthcare Hospital.

Results

①The average age of the 16 patients was (30.4±4.0) years old, the average number of previous intrauterine operations was (2.6±2.4) times, the average cervical dilatation at admission was (3.9±2.7) cm, mean gestational age at CC was (22.3±2.2) weeks and (29.4±6.3) weeks at delivery, the average prolongation of pregnancy after CC was (49.9±41.6) days, the average birth weight of survival newborns was (2.2±1.0) kg, and the fatality rate of fetus after birth was 37.5%(6/16). ②The maternal age and the number of previous intrauterine operations of the nonsurvival group were older or more than those of survival group, while the gestational age at delivery, prolongation of pregnancy after CC and neonatal birth weight were less than those of survival group, and the differences were statistically significant(P<0.05). There were no significant differences between two groups in the degree of cervical dilatation and the gestational age at CC (P>0.05).

Conclusion

Maternal age and the number of previous intrauterine operations may affect the pregnancy outcomes in mid-trimester UCI patients with emergency CC treatment.

Key words: Uterine cervical incompetence, Cerclage, cervical, Pregnancy trimester, second, Pregnancy outcome, Female

表1 2组中孕期宫颈功能不全患者临床特点比较(±s)

组别	例数	年龄(岁)	既往宫腔操作次数(次)	宫颈外口扩张程度(cm)	手术时孕龄(周)	分娩时孕龄(周)	术后延长妊娠时间(d)	新生儿出生体重(kg)
胎儿未存活组	6	33.0±5.2	4.7±2.4	3.1±2.8	21.1±1.7	22.6±2.1	10.5±8.6	0.5±0.1
胎儿存活组	10	28.9±2.2	1.4±1.5	4.4±2.7	23.0±2.2	33.5±3.7	73.6±34.5	2.2±1.0
t值	?	2.22	3.36	－0.90	－1.79	－6.51	－5.51	－5.53
P值	?	0.040	<0.001	0.390	0.100	<0.001	<0.001	<0.001

表1 2组中孕期宫颈功能不全患者临床特点比较(±s)

组别	例数	年龄(岁)	既往宫腔操作次数(次)	宫颈外口扩张程度(cm)	手术时孕龄(周)	分娩时孕龄(周)	术后延长妊娠时间(d)	新生儿出生体重(kg)
胎儿未存活组	6	33.0±5.2	4.7±2.4	3.1±2.8	21.1±1.7	22.6±2.1	10.5±8.6	0.5±0.1
胎儿存活组	10	28.9±2.2	1.4±1.5	4.4±2.7	23.0±2.2	33.5±3.7	73.6±34.5	2.2±1.0
t值	?	2.22	3.36	－0.90	－1.79	－6.51	－5.51	－5.53
P值	?	0.040	<0.001	0.390	0.100	<0.001	<0.001	<0.001

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