Exploring the safety of treating cervical insufficiency at different surgical times
Objective To investigate the effects of different operation timing on oxidative stress and pregnancy outcome of patients with cervical insufficiency.Methods 93 patients with cervical insufficiency who were treated in Qinhuangdao Maternal and Child Health Hospital from January 2021 to September 2022 were selected.According to the treatment methods,they were divided into expectant treatment group,pregnancy surgery group and non-pregnancy surgery group,with 31 cases in each group.The expectant therapy group received routine expectant therapy treatment,the pregnancy surgery group received vaginal and cervical cerclage treatment in mid pregnancy,and the non-pregnancy surgery group received prophylactic vaginal and cervical cerclage treatment before pregnancy.Compared the operation-related indicators,oxidative stress indicators and surgical complications in the pregnant and non-pregnant surgery groups,and calculated the pregnancy outcomes of three groups.Results Compared with the pregnancy surgery group,the hospitalization time in the non-pregnancy surgery group was significantly shortened(P<0.05).There was no statistically significant difference in the total antioxidant capacity(T-AOC),superoxide dismutase(SOD),and malondialdehyde(MDA)levels between the pregnancy surgery group and the non-pregnancy surgery group at T1 time point(P>0.05);at time points T2 and T3,the levels of T-AOC and SOD in the two groups of patients decreased,while MDA levels increased,with the highest being at time point T2(P<0.05);at time points T2 and T3,the T-AOC and SOD levels in the non-pregnancy surgery group were higher than those in the pregnancy surgery group,while MDA levels were lower than those in the pregnancy surgery group(P<0.05).The overall incidence of surgical complications in the non-pregnancy surgery group was lower than that in the pregnancy surgery group,but there was no significant difference between the two groups(P>0.05).Compared with the expectant therapy group,the incidence of total adverse pregnancy outcomes was reduced in the pregnancy surgery group and the non-pregnancy surgery group,with the non-pregnancy surgery group having the lowest overall incidence of adverse pregnancy outcomes(P<0.05).Conclusion The pregnancy outcome obtained by transvaginal cervical ceration is better than that obtained by expectant therapy in the treatment of cervical insufficiency,especially prophylactic vaginal cervical ceration before pregnancy,which may be related to less oxidative stress and higher safety caused by prophylactic vaginal cervical ceration.
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