同济大学学报（医学版）2024，Vol.45Issue(4)：496-502,7.DOI:10.12289/j.issn.2097-4345.24219
两种Shirodkar宫颈环扎术式对单胎宫颈机能不全孕妇妊娠结局的影响
Pregnancy outcomes of singleton pregnant women with cervical insufficiency receiving Shirodkar cervical cerclage with or without buried sutures
摘要
Abstract
Objective To compare the pregnancy outcomes in singleton pregnant women with cervical insufficiency receiving Shirodkar cerclage with or without buried sutures.Methods A total of 373 singleton pregnant women with cervical insufficiency who underwent transvaginal cervical cerclage(Shirodkar technique)at the Obstetrics Department of Tongji University Affiliated East Hospital from February 2021 to December 2023 were enrolled in the study.During the Shirodkar cerclage procedures the sutures were buried in 115 cases(buried suture group)and not buried in 258 cases(non-buried suture group).Independent sample t-tests,rank-sum tests,chi-square tests,or Fisher's exact tests were used to compare general clinical data,pregnancy outcomes,and neonatal outcomes between the two groups.Multivariate Logistic regression models were used to analyze the risk factors for preterm birth and cerclage removal before 36 weeks of gestation.Results Compared with the non-buried suture group,the buried suture group had a lower rate of preterm birth(13.0% vs 22.5% ,P=0.048),a lower rate of cerclage removal before 36 weeks(19.1% vs 33.3% ,P=0.005),and a later gestational week at cerclage removal[37(36.0,37.0)weeks vs 36(35.0,37.0)weeks,P＜0.001].There were no significant differences between the two groups in neonatal outcomes,including birth weight,NICU admission rate,and neonatal complications(all P＞0.05).Multivariate Logistic regression analysis showed that the presence of buried sutures was not significantly associated with a reduced risk of preterm birth but was associated with a reduced risk of cerclage removal before 36 weeks(OR=0.516,95% CI:0.293-0.909,P=0.022).Cervical length before cerclage was associated with a reduced risk of preterm birth(OR=0.954,95% CI:0.915-0.996,P=0.031)and an increased rate of cerclage removal before 36 weeks(OR=1.062,95% CI:1.002-1.104,P=0.002).Conclusion The Shirodkar cerclage with buried sutures can prolong gestational age at cerclage removal and reduce the rate of cerclage removal before 36 weeks,but it does not show a significant advantage in improving overall pregnancy outcomes.关键词
宫颈机能不全/宫颈环扎术/Shirodkar术式/妊娠结局Key words
cervical insufficiency/cervical cerclage/Shirodkar technique/pregnancy outcomes分类
医药卫生引用本文复制引用
刘云,雷胜瑶,倪晓田,徐文怡,汝萍,刘铭..两种Shirodkar宫颈环扎术式对单胎宫颈机能不全孕妇妊娠结局的影响[J].同济大学学报（医学版）,2024,45(4):496-502,7.基金项目
上海市浦东新区卫生系统重点专科建设资助项目(PWZzk2022-11) （PWZzk2022-11）
