国际妇产科学杂志 ›› 2018, Vol. 45 ›› Issue (6): 704-707.

• 论著 • 上一篇    下一篇

减胎术联合宫颈环扎术治疗多胎妊娠并宫颈机能不全2例临床分析

方炼砂,李映桃,钟彩娟,郭慧,王振宇,陈敏,李志华   

  1. 510150  广州医科大学附属第三医院产科(方炼砂,李映桃,钟彩娟,郭慧,王振宇),产前诊断科、广州重症孕产妇救治中心、广东省产科重大疾病重点实验室(陈敏,李志华)
  • 收稿日期:2018-06-08 修回日期:2018-08-30 出版日期:2018-12-15 发布日期:2018-12-15
  • 通讯作者: 李映桃,E-mail:yingtao9777@163.com E-mail:yingtao9777@163.com

The Clinical Analysis of Two Cases of Multiple Pregnancy with Cervical Incompetence Treated by Reduction of Fetus and Cervical Cerclage

FANG Lian-sha,LI Ying-tao,ZHONG Cai-juan,GUO Hui,WANG Zhen-yu,CHEN Min,LI Zhi-hua   

  1. Department of Obstetrics(FANG Lian-sha,LI Ying-tao,ZHONG Cai-juan,GUO Hui,WANG Zhen-yu),Department of Prenatal Diagnosis,Guangzhou Medical Center for Critical Pregnant Women,Key Laboratory for Major Obstetric Disease of Guangdong Province(CHEN Min,LI Zhi-hua),The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China
  • Received:2018-06-08 Revised:2018-08-30 Published:2018-12-15 Online:2018-12-15
  • Contact: LI Ying-tao,E-mail:yingtao9777@163.com E-mail:yingtao9777@163.com

摘要: 多胎妊娠、宫颈机能不全等均是流产或早产的高危因素,若多胎妊娠患者合并宫颈机能不全则流产或早产的风险更高。现报道2例多胎妊娠合并宫颈机能不全患者,分别在孕11+5周和20+5周行减胎术,随后分别在13+4周和21+6周行宫颈环扎术,定期产检阴道超声监测宫颈长度并及时预防早产治疗,分别在孕36周和孕33+4周成功顺产活婴,认为减胎术是多胎妊娠改善妊娠结局的补救措施,减胎术后行宫颈环扎术可修复宫颈的机能,而定期随访对防治早产、指导临床用药及适时拆除宫颈环扎线并改善母儿预后至关重要。当多胎妊娠合并宫颈机能不全时,采用减胎术联合宫颈环扎术进行治疗是一个可供临床借鉴的选择方案。

关键词: 妊娠减少, 多胎, 环扎术, 宫颈, 宫颈功能不全, 预后

Abstract: Multiple pregnancies and cervical incompetence are high risk factors for miscarriage or premature delivery. If multiple pregnancies complicated with cervical incompetence, the risk of miscarriage or premature delivery is higher. Two cases of multiple pregnancy complicated with cervical incompetence were reported. Multifetal pregnancy reduction was performed at 11+5 weeks of gestation and 20+5 weeks of gestation. Cervical cerclage was performed at 13+4 weeks of gestation and 21+6 weeks of gestation respectively. The cervical length was monitored by vaginal ultrasound and preterm delivery was prevented. The cases of multiple pregnancy complicated with cervical incompetence were born at 36 weeks of gestation and 33+4 weeks of gestation respectively. The clinical course was analyzed and evaluated. Cervical cerclage is a remedy to improve pregnancy outcome in multiple pregnancies. Cervical cerclage can repair the cervical function after multifetal pregnancy reduction. Periodic follow-up is very important to prevent premature delivery, so are clinical medication and removing cervical cerclage stitches in time to improve maternal and fetal prognosis. When multiple pregnancy complicated with cervical incompetence, multifetal pregnancy reduction combined with cervical cerclage is a choice for clinic practice.

Key words: Pregnancy reduction, multifetal, Cerclage, cervical, Uterine cervical incompetence, Prognosis