摘要
目的:探讨双胎妊娠宫颈机能不全患者的不同处理对妊娠结局影响的临床意义。方法:回顾性分析本院2013年1月—2016年10月住院分娩的352例双胎妊娠患者,随访观察采用辅助生殖技术双胎妊娠患者宫颈机能不全发病率及临床诊断为宫颈功能不全患者不同处理对妊娠结局的影响。结果:采用辅助生殖技术双胎妊娠的孕妇发生宫颈功能不全[13.66%(22/161)与4.19%(8/191),χ~2=10.062,P=0.002]较自然受孕双胎妊娠妇女的发病率高。22例患者要求实施经阴道宫颈环扎术后延长孕周[(15.27±6.79)与(2.79±5.75)周,t=4.619,P<0.001]较8例保守治疗患者延长孕周长,且获得活胎率高(81.82%)。20周内实施经阴道宫颈环扎术患者延长孕周([16.75±6.27)与(8.75±4.20)周,t=-7.320,P<0.001]较20周后实施宫颈环扎患者孕周长。采用预防性宫颈环扎术患者延长孕周[(19.36±3.61)与(8.13±4.73)周,t=6.276,P<0.001](19.36±3.61)高于应急性环扎术患者(8.13±4.73)。结论:采用辅助生殖技术双胎妊娠妇女宫颈机能不全发病率较自然受孕双胎妊娠者高;双胎妊娠宫颈机能不全患者选择合适的手术时机和妊娠孕周实施经阴道宫颈环扎术可以延长孕周,对改善妊娠结局是有益的。
Objective： To investigate the effects of different treatments of cervical insufficiency in twin pregnancy on pregnancy outcome.Methods： A retrospective analysis of our hospital in January 2013 -2016 year in October the hospital delivery in 352 cases of twin pregnancies, followed by assisted reproductive technology of twin pregnancies patients the incidence and clinical diagnosis for cervical insufficiency in patients with different treatment on pregnancy outcome.Results ： The incidence of cervical incompetence in women with twin pregnancies with assisted reproductive technology[13.66% （22/161） and 4.19% （8/191）, X2=10.062,/9=-0.002] was higher than that of natural pregnancy. 22 cases of patients with cervical cerclage and required to surgical treatment were prolonged gestational weeks [（15.27± 6.79） and （2.79 ± 5.75） weeks, t=-4.619, P 〈 0.001] than 8 cases of patients with expectant treament and high rate of live births （81.82%）. 20 weeks after cervical cerclage with prolongation of gestation [（16.75± 6.27} and （8.75±4.20} weeks, t=-7.320, P 〈 0.001] more than 20 weeks pregnant patients underwent cervical cerclage. The prevention of patients with cervical cerclage of prolongation of gestation [（19.36 ±3,61} and （8.13± 4.73） weeks, t=6.276, P 〈 0.001] （19.36 ± 3.61} higher than that of patients with emergency cerclage （8.13 ±4.73}. In the elective cerclage group,these women who were cerclaged before 20th gestation week[（16,75±6.27） and （8.75±4.20） weeks, t=-7.320, P 〈 0.001],could get longer gestational weeks than the women who were cerclaged after 20th gestation week.An elective cerclage could get longer gestational weeks[（19.36±3.61} and （8.13±4.73} weeks, t=6.276, P 〈 0.001] than emergency cerclage.Conclusions： The cervical incompetence incidence rate in assisted reproductive technology of twin pregnancies group was higher than that in naturally conceived twin pregnancies group. The cervical cerclage of choosing the appropriate timing of surgery and weeks of gestation can prolong gestational age in patients with cervical incompetence for twin pregnancies, is beneficial to improve the outcome of pregnancy.
出处
《影像研究与医学应用》
2017年第1期211-213,共3页
Journal of Imaging Research and Medical Applications
关键词
双胎妊娠
宫颈功能不全
辅助生殖技术
宫颈环扎术
妊娠结局
Twin pregnancies
Cervical incompetence
Cervical cerclage
Assisted reproductive technology
pregnancyoutcome
