Research progress on cervical cerclage for preventing preterm birth in twin pregnancies
吴培莉 1薛晴 1刘璇璇 2孙笑 1李晔
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作者信息
1. 北京大学第一医院妇产生殖医学中心，北京 100034
2. 锡林郭勒盟中心医院妇产科，锡林浩特 026000
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摘要
早产是双胎妊娠最常见的产科并发症。宫颈环扎术是近年来双胎早产预防措施的研究热点，其在双胎妊娠宫颈机能不全的临床应用价值存在一定的争议。此外，感染（炎症）状态与双胎宫颈环扎术后的妊娠结局也密切相关。研究推荐对于宫颈长度≤15 mm或宫颈扩张的双胎妊娠孕妇行宫颈环扎术，暂不推荐对于宫颈长度15~25 mm和以病史为指征的双胎妊娠患者行宫颈环扎术。双胎宫颈环扎术前评估羊膜腔内感染或炎症的临床意义有待进一步探究，但需排除抗生素使用对手术治疗效果评价的影响。 Preterm birth is the most common maternal complication in twin pregnancies. In recent years, cervical cerclage has been of long-standing interest in the prevention of preterm birth in twin pregnancies. However, its clinical application in the treatment of cervical insufficiency of twin pregnancies remains a controversial subject. In addition, infection or inflammation conditions are considered to be closely related to the perinatal outcomes of twin pregnancies after cervical cerclage. This paper reviews the research progress on cervical cerclage in twin pregnancies, recommending cervical cerclage for twin pregnancies with cervical length≤15 mm or cervical dilatation, while it is not suggested for those with cervical length of 15-25 mm or history-indicated cervical cerclage. The clinical significance of preoperative evaluation of intraamniotic infection or inflammation of twin pregnancies needs to be further explored, but it is necessary to avoid the effect of antibiotic use on the evaluation of surgical effects.
Abstract
Preterm birth is the most common maternal complication in twin pregnancies. In recent years, cervical cerclage has been of long-standing interest in the prevention of preterm birth in twin pregnancies. However, its clinical application in the treatment of cervical insufficiency of twin pregnancies remains a controversial subject. In addition, infection or inflammation conditions are considered to be closely related to the perinatal outcomes of twin pregnancies after cervical cerclage. This paper reviews the research progress on cervical cerclage in twin pregnancies, recommending cervical cerclage for twin pregnancies with cervical length≤15 mm or cervical dilatation, while it is not suggested for those with cervical length of 15-25 mm or history-indicated cervical cerclage. The clinical significance of preoperative evaluation of intraamniotic infection or inflammation of twin pregnancies needs to be further explored, but it is necessary to avoid the effect of antibiotic use on the evaluation of surgical effects.
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