子宫畸形妊娠合并宫颈机能不全23例临床探析.doc

子宫畸形妊娠合并宫颈机能不全23例临床探析 　　doi：10.3969/j.issn.1007-614x.2013.19.42 摘 要 目的：探讨宫颈环扎术在子宫畸形妊娠合并宫颈机能不全患者中应用的临床效果。方法：将23例子宫畸形妊娠合并宫颈机能不全患者分别分为妊娠前诊断组、妊娠期诊断组及宫颈环扎术组、保守治疗组。对比各组保胎天数、30周以上、34周以上及37周以上分娩率。结果：妊娠前诊断组34周以上分娩率高于妊娠期诊断组；实施宫颈环扎术者30周及34周以上、37周以下分娩率高于保守治疗组。结论：对子宫畸形合并宫颈机能不全患者进行早诊断、于14～16周行预防性宫颈环扎术，可以降低流产、早产发生率及围生儿死亡率。 关键词 子宫畸形 宫颈机能不全 妊娠 Clinical analysis of 23 pregnant cases with uterine malformation complicated with cervical incompetence LI Jing Department of Gynecology and Obstetrics，Women and Childrens ‘s Hospital of Jinzhou，Jinzhou 121000，China Abstract Objective：To explore the clinical effect of cerclage of cervix used in pregnant cases with uterine malformation complicated with cervical incompetence.Methods：Twenty three cases were divided into Prepregnancy diagnosis group and Pregnancy diagnosis group according the time of diagnosis.Divided into Cervical cerclage group and Conservative treatment group according the therapeutic method.Compared the delivery rate of patient that gestational weeks more than 30 weeks，34 weeks and 37 weeks.Results：Delivery rate of gstational weeks more than 34 weeks of Pre pregnancy diagnosis group was higher than that of Pregnancy diagnosis group，that more than 30 weeks and 34 weeks but less than 37 weeks of Cervical cerclage group was higher than Conservative treatment group.Conclusion：Early diagnosis of cervical incompetence and the implementation of cervical cerclage at 14～16 weeks can reduce the abortion rate，the rate of premature delivery and perinatal mortality. Key words uterine malformation；cervical incompetence；pregnancy 子宫发育异常包括双子宫、双角子宫、中隔子宫、单角子宫等，合并子宫畸形患者不仅容易发生不孕，而且怀孕后流产、早产及胎位异常发病率大大增加，给患者的身体及心理均造成损害。我们在认识宫腔异常增加上述情况外，还要重视宫颈机能不全所造成的影响。宫颈机能不全（CIC）即中期妊娠或晚期妊娠的子宫颈无痛性扩张[1]，可先天性及后天性因素引起，文献报道，子宫畸形患者常伴有宫颈机能不全的发生，其原因可能有子宫畸形患者宫颈组织学缺陷、宫颈弹力蛋白含量不足有关。 2005～2012年收治子宫畸形妊娠合并宫颈功能不全患者23例，对无手术禁忌者行宫颈环扎术，效果良好，现报告如下。 资料与方法 2005～2012年收治子宫畸形妊娠合并宫颈机能不全患者23例，年龄24～37岁，平均28.7岁；孕周14～30周，平均21.5周；孕次1～4次，孕次中位数2次。入院时均为活胎。妊娠前诊断8例，妊娠期