
国际生殖健康/计划生育 ›› 2022, Vol. 41 ›› Issue (6): 514-518.doi: 10.12280/gjszjk.20220405
收稿日期:2022-08-15
									
				
									
				
									
				
											出版日期:2022-11-15
									
				
											发布日期:2022-11-18
									
			通讯作者:
					李增彦
											E-mail:li_zengyan@sina.com
												基金资助:
        
               		SU Jing, GAO Xiao-li, LI Zeng-yan( )
)
			  
			
			
			
                
        
    
Received:2022-08-15
									
				
									
				
									
				
											Published:2022-11-15
									
				
											Online:2022-11-18
									
			Contact:
					LI Zeng-yan   
											E-mail:li_zengyan@sina.com
												摘要:
宫颈机能不全的特点是在妊娠中、晚期出现的无痛性宫颈扩张和缩短,是引起反复晚期流产及早产的常见原因。由于宫颈机能不全的诊断难以精准,其发病机制尚不明确,国内外尚无统一的规范。作为一种监测手段,经阴道超声监测宫颈长度对治疗有一定的指导作用。宫颈环扎术是宫颈机能不全最简单有效的治疗方式,根据手术方式可分为经阴道宫颈环扎术和经腹宫颈环扎术,根据手术指征可分为病史指征的宫颈环扎术、超声指征的宫颈环扎术和紧急环扎术。宫颈环扎术的术后管理及拆线时机需进行个性化选择。
苏婧, 高晓丽, 李增彦. 宫颈机能不全与宫颈环扎术[J]. 国际生殖健康/计划生育, 2022, 41(6): 514-518.
SU Jing, GAO Xiao-li, LI Zeng-yan. Cervical Insufficiency and Cervical Cerclage[J]. Journal of International Reproductive Health/Family Planning, 2022, 41(6): 514-518.
| [1] | Alfirevic Z, Stampalija T, Medley N. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy[J]. Cochrane Database Syst Rev, 2017, 6(6):CD008991. doi: 10.1002/14651858.CD008991.pub3. doi: 10.1002/14651858.CD008991.pub3 | 
| [2] | Brown R, Gagnon R, Delisle MF.  No. 373-Cervical Insufficiency and Cervical Cerclage[J]. J Obstet Gynaecol Can, 2019, 41(2):233-247. doi: 10.1016/j.jogc.2018.08.009. doi: S1701-2163(18)30649-2 pmid: 30638557 | 
| [3] | Roman A, Suhag A, Berghella V.  Overview of Cervical Insufficiency: Diagnosis, Etiologies, and Risk Factors[J]. Clin Obstet Gynecol, 2016, 59(2):237-240. doi: 10.1097/GRF.0000000000000184. doi: 10.1097/GRF.0000000000000184 pmid: 27015229 | 
| [4] | Mastrolia SA, Baumfeld Y, Hershkovitz R, et al.  Bicornuate uterus is an independent risk factor for cervical os insufficiency: A retrospective population based cohort study[J]. J Matern Fetal Neonatal Med, 2017, 30(22):2705-2710. doi: 10.1080/14767058.2016.1261396. doi: 10.1080/14767058.2016.1261396 pmid: 27903074 | 
| [5] | Han Y, Li M, Ma H, et al.  Cervical insufficiency: a noteworthy disease with controversies[J]. J Perinat Med, 2020, 48(7):648-655. doi: 10.1515/jpm-2020-0255. doi: 10.1515/jpm-2020-0255 pmid: 32692707 | 
| [6] | Prediction and Prevention of Spontaneous Preterm Birth: ACOG Practice Bulletin, Number 234[J]. Obstet Gynecol, 2021, 138(2):e65-e90. doi: 10.1097/AOG.0000000000004479. doi: 10.1097/AOG.0000000000004479 pmid: 34293771 | 
| [7] | Reicher L, Fouks Y, Yogev Y. Cervical Assessment for Predicting Preterm Birth-Cervical Length and Beyond[J]. J Clin Med, 2021, 10(4):627. doi: 10.3390/jcm10040627. doi: 10.3390/jcm10040627 URL | 
| [8] | 夏恩兰. 宫颈锥切及根治性宫颈切除术后宫颈环扎问题[J]. 国际生殖健康/计划生育杂志, 2017, 36(3):181-184,233. doi: 10.3969/j.issn.1674-1889.2017.03.001. doi: 10.3969/j.issn.1674-1889.2017.03.001 | 
| [9] | Panelli DM, Wood RL, Elias KM, et al.  The Loop Electrosurgical Excision Procedure and Cone Conundrum: The Role of Cumulative Excised Depth in Predicting Preterm Birth[J]. AJP Rep, 2022, 12(1):e41-e48. doi: 10.1055/s-0041-1742271. doi: 10.1055/s-0041-1742271 pmid: 35141035 | 
| [10] | 侯悦, 乔宠. 辅助生殖技术妊娠和宫颈机能不全[J]. 中华产科急救电子杂志, 2019, 8(3):151-154. doi: 10.3877/cma.j.issn.2095-3259.2019.03.006. doi: 10.3877/cma.j.issn.2095-3259.2019.03.006 | 
| [11] | Barinov SV, Artymuk NV, Novikova ON, et al.  Analysis of risk factors and predictors of pregnancy loss and strategies for the management of cervical insufficiency in pregnant women at a high risk of preterm birth[J]. J Matern Fetal Neonatal Med, 2021, 34(13):2071-2079. doi: 10.1080/14767058.2019.1656195. doi: 10.1080/14767058.2019.1656195 URL | 
| [12] | Bordi G, D′Ambrosio A, Gallotta I, et al. The influence of ovulation induction and assisted conception on maternal and perinatal outcomes of twin pregnancies[J]. Eur Rev Med Pharmacol Sci, 2017, 21(18):3998-4006. | 
| [13] | Gökçe A, Şükür YE, Özmen B, et al.  The association between operative hysteroscopy prior to assisted reproductive technology and cervical insufficiency in second trimester[J]. Arch Gynecol Obstet, 2021, 303(5):1347-1352. doi: 10.1007/s00404-020-05863-1. doi: 10.1007/s00404-020-05863-1 URL | 
| [14] | ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency[J]. Obstet Gynecol, 2014, 123(2 Pt 1):372-379. doi: 10.1097/01.AOG.0000443276.68274.cc. doi: 10.1097/01.AOG.0000443276.68274.cc pmid: 24451674 | 
| [15] | 王晓怡, 陈敦金. 宫颈机能不全的孕前诊断方法及评价[J]. 中国实用妇科与产科杂志, 2014, 30(2):90-93. | 
| [16] | Berghella V, Saccone G. Cervical assessment by ultrasound for preventing preterm delivery[J]. Cochrane Database Syst Rev, 2019, 9(9):CD007235. doi: 10.1002/14651858.CD007235.pub4. doi: 10.1002/14651858.CD007235.pub4 | 
| [17] | Shennan AH, Story L, Royal College of Obstetricians and Gynaecologists. Cervical Cerclage: Green-top Guideline No. 75[J]. BJOG, 2022, 129(7):1178-1210. doi: 10.1111/1471-0528.17003. doi: 10.1111/1471-0528.17003 URL | 
| [18] | 胡娅莉. 早产临床诊断与治疗指南(2014)[J]. 中华妇产科杂志, 2014, 49(7):481-485. doi: 10.3760/cma.j.issn.0529-567x.2014.07.001. doi: 10.3760/cma.j.issn.0529-567x.2014.07.001 | 
| [19] | 姚书忠. 宫颈机能不全诊治过程中存在的争议和思考[J]. 中国实用妇科与产科杂志, 2017, 33(1):31-35. doi: 10.19538/j.fk2017010108. doi: 10.19538/j.fk2017010108 | 
| [20] | Gulersen M, Bornstein E, Domney A, et al.  Cerclage in singleton gestations with an extremely short cervix (≤10 mm) and no history of spontaneous preterm birth[J]. Am J Obstet Gynecol MFM, 2021, 3(5):100430. doi: 10.1016/j.ajogmf.2021.100430. doi: 10.1016/j.ajogmf.2021.100430 URL | 
| [21] | Ehsanipoor RM, Seligman NS, Saccone G, et al.  Physical Examination-Indicated Cerclage: A Systematic Review and Meta-analysis[J]. Obstet Gynecol, 2015, 126(1):125-135. doi: 10.1097/AOG.0000000000000850. doi: 10.1097/AOG.0000000000000850 pmid: 26241265 | 
| [22] | Wierzchowska-Opoka M, Kimber-Trojnar Ż, Leszczyńska-Gorzelak B. Emergency Cervical Cerclage[J]. J Clin Med, 2021, 10(6):1270. doi: 10.3390/jcm10061270. doi: 10.3390/jcm10061270 URL | 
| [23] | 中华医学会围产医学分会胎儿医学学组, 中华医学会妇产科学分会产科学组. 双胎妊娠临床处理指南(2020年更新)[J]. 中国产前诊断杂志(电子版), 2021, 13(1):51-63. doi: 10.13470/j.cnki.cjpd.2021.01.011. doi: 10.13470/j.cnki.cjpd.2021.01.011 | 
| [24] | Odibo AO, Berghella V, To MS, et al.  Shirodkar versus McDonald cerclage for the prevention of preterm birth in women with short cervical length[J]. Am J Perinatol, 2007, 24(1):55-60. doi: 10.1055/s-2006-958165. doi: 10.1055/s-2006-958165 URL | 
| [25] | Liddiard A, Bhattacharya S, Crichton L. Elective and emergency cervical cerclage and immediate pregnancy outcomes: a retrospective observational study[J]. JRSM Short Rep, 2011, 2(11):91. doi: 10.1258/shorts.2011.011043. doi: 10.1258/shorts.2011.011043 pmid: 22140617 | 
| [26] | Clark NV, Einarsson JI. Laparoscopic abdominal cerclage: a highly effective option for refractory cervical insufficiency[J]. Fertil Steril, 2020, 113(4):717-722. doi: 10.1016/j.fertnstert.2020.02.007. doi: S0015-0282(20)30099-6 pmid: 32147177 | 
| [27] | Shennan A, Chandiramani M, Bennett P, et al.  MAVRIC: a multicenter randomized controlled trial of transabdominal vs transvaginal cervical cerclage[J]. Am J Obstet Gynecol, 2020, 222(3):261.e1-261.e9. doi: 10.1016/j.ajog.2019.09.040. doi: 10.1016/j.ajog.2019.09.040 | 
| [28] | Tulandi T, Alghanaim N, Hakeem G, et al.  Pre and post-conceptional abdominal cerclage by laparoscopy or laparotomy[J]. J Minim Invasive Gynecol, 2014, 21(6):987-993. doi: 10.1016/j.jmig.2014.05.015. doi: 10.1016/j.jmig.2014.05.015 URL | 
| [29] | Eleje GU, Eke AC, Ikechebelu JI, et al.  Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies[J]. Cochrane Database Syst Rev, 2020, 9(9):CD012871. doi: 10.1002/14651858.CD012871.pub2. doi: 10.1002/14651858.CD012871.pub2 | 
| [30] | Oh KJ, Romero R, Park JY, et al.  Evidence that antibiotic administration is effective in the treatment of a subset of patients with intra-amniotic infection/inflammation presenting with cervical insufficiency[J]. Am J Obstet Gynecol, 2019, 221(2):140.e1-140.e18. doi: 10.1016/j.ajog.2019.03.017. doi: 10.1016/j.ajog.2019.03.017 | 
| [31] | McIntosh J, Feltovich H, Berghella V, et al.  The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention[J]. Am J Obstet Gynecol, 2016, 215(3):B2-B7. doi: 10.1016/j.ajog.2016.04.027. doi: 10.1016/j.ajog.2016.04.027 | 
| [32] | Cai B, Xia Y, Na X. Correlation Between Clinical Factors and Pregnancy Outcome Following Repeat Cerclage: A Retrospective Analysis of a Chinese Population[J]. Front Med(Lausanne), 2022, 9:846755. doi: 10.3389/fmed.2022.846755. doi: 10.3389/fmed.2022.846755 | 
| [33] | Giraldo-Isaza MA, Berghella V. Cervical cerclage and preterm PROM[J]. Clin Obstet Gynecol, 2011, 54(2):313-320. doi: 10.1097/GRF.0b013e318217d530. doi: 10.1097/GRF.0b013e318217d530 pmid: 21508701 | 
| [1] | 赵安琪, 刘霖, 谭小方. HPV经精子传播及其对早期胚胎发育的影响[J]. 国际生殖健康/计划生育杂志, 2024, 43(4): 328-331. | 
| [2] | 宋秋瑾, 钱晓红, 陈骞. 肠道菌群与妊娠并发症相关性的研究进展[J]. 国际生殖健康/计划生育杂志, 2023, 42(5): 409-413. | 
| [3] | 何玥, 崔红梅. 铁死亡在产科疾病中的研究进展[J]. 国际生殖健康/计划生育杂志, 2023, 42(5): 414-418. | 
| [4] | 朱梦一, 高敬书, 王宇, 冯佳兴, 张蓓, 吴效科. 生长分化因子15与不良妊娠结局的研究进展[J]. 国际生殖健康/计划生育杂志, 2023, 42(5): 419-423. | 
| [5] | 裴娇娇, 黄超林, 陈蛟. 铁死亡与胎盘源性疾病的研究进展[J]. 国际生殖健康/计划生育, 2022, 41(5): 425-429. | 
| [6] | 倪丹玉, 季慧, 谢奇君, 凌秀凤. 宫颈机能不全在辅助生殖技术中的研究进展[J]. 国际生殖健康/计划生育, 2022, 41(1): 42-45. | 
| [7] | 任军丽, 杨柳, 黎燕, 黄丽娟, 李雪娇, 李海鸿. 我国早产儿视网膜病发病率的Meta分析[J]. 国际生殖健康/计划生育, 2021, 40(6): 462-467. | 
| [8] | 刘广谱, 张惠欣. 双胎妊娠第二胎延迟分娩三例及文献复习[J]. 国际生殖健康/计划生育, 2020, 39(5): 387-390. | 
| [9] | 刘建华, 王玉贤, 赵惠玲, 郗晓丽. 经阴道宫颈环扎术——MacDonald术式应用于双胎妊娠的妊娠结局分析 #br#[J]. 国际生殖健康/计划生育, 2020, 39(4): 280-283. | 
| [10] | 郭丽娜,刘盼,赵敏英,廖英,苏雅琴,田瑜. 人工授精和自然妊娠早期自然流产绒毛染色体异常相关因素分析[J]. 国际生殖健康/计划生育, 2020, 39(3): 195-198. | 
| [11] | 任丽杰,刘倩,夏春玲,杨艳. 早产原因相关研究热点的文献计量学分析[J]. 国际生殖健康/计划生育, 2020, 39(2): 126-130. | 
| [12] | 郭丽娜,廖英,刘盼,田瑜,赵敏英,苏雅琴. 早期自然流产绒毛染色体检查与相关遗传咨询的关系[J]. 国际生殖健康/计划生育, 2020, 39(2): 109-112. | 
| [13] | 郭丽娜,赵敏英,刘盼. 高通量测序技术检测自然流产绒毛染色体异常的准确性分析[J]. 国际生殖健康/计划生育, 2020, 39(1): 26-29. | 
| [14] | 王舒可,郑梅玲. 卵泡刺激素受体在胎盘血管形成及维持妊娠中的作用[J]. 国际生殖健康/计划生育, 2019, 38(5): 418-421. | 
| [15] | 俞田田,洪丽华. 早期妊娠丢失蜕膜组织中与血管重塑相关的miRNAs表达谱分析 [J]. 国际生殖健康/计划生育, 2019, 38(1): 43-47. | 
| 阅读次数 | ||||||
| 全文 |  | |||||
| 摘要 |  | |||||