Comparison of pregnancy outcomes after transvaginal cervical cerclage for different surgical indications during pregnancy / 中国实用妇科与产科杂志

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 surgerythose 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（P0.05）.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（P0.05）.The abortion rate（71.42%）in group E was higher than that in group H（13.04%）and group U（00.00%）（P0.05）.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.