Analysis of outcomes of different treatments in pregnant women with short cervix at 14-31+6 weeks of pregnancy and influencing factors for preterm labor
Objective To analyze the outcomes of different treatments in pregnant women with short cervix at 14-31+6 weeks of pregnancy and the influencing factors for preterm labor.Methods The clinical data of 205 singleton pregnant women with cervical length ≤25 mm at 14-31+6 weeks of gestation were analyzed retrospectively,who were divided into pessary group(87 cases)and control group(118 cases)according to different treatment methods.According to the different gestational weeks,the pessary group was further divided into group A(14-27+6 weeks,57 cases)and group B(28-31+6 weeks,30 cases)and the control group was further divided into group C(14-27+6 weeks,55 cases)and group D(28-31+6 weeks,63 cases).The pregnancy and neonatal outcomes were compared among the groups and the influencing factors for preterm labor were analyzed.Results The pregnancy prolongation time and gestational weeks of delivery were longer,the delivery rates of＜28 weeks,＜32 weeks,＜34 weeks and＜37 weeks were lower,the incidence of vaginitis and neonatal survival rate were higher,and the proportion of neonatal mechanical ventilation and intensive care were lower in pessary group than those in control group(P＜0.05).The gestational weeks of delivery were longer,the delivery rates of＜28 weeks,＜32 weeks and＜34 weeks were lower,and the neonatal survival rate was higher in group A than those in group C(P＜0.05).The pregnancy prolongation time and gestational weeks of delivery were longer,the delivery rate of＜37 weeks was lower,and the proportion of neonatal intensive care was lower in group B than those in group D(P＜0.05).Multivariate logistic regression analysis showed that shorter cervix,no use of pessary,older age,lower education and chorioamnionitis were the independent risk factors for preterm labor(P＜0.05).Conclusion The use of pessary in singleton women with short cervix at 14-31+6 weeks of gestation can prolong pregnancy and gestational weeks of delivery and reduce preterm labor rates.Interventions at 14-27+6 weeks of gestation can increase neonatal survival,and interventions at 28-31+6 weeks of gestation can decrease the proportion of neonatal intensive care.Cervical length,use of pessary,age,education and chorioamnionitis are associated with preterm labor.
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