22 Cases Of Prophylactic Laparoscopy Cervical Cerclage After Cervical Conization Were Analysed Retrospectively

ObjectiveIn this paper, we collection 158 patients with cervical conization to analysis the influence of cervical cone cutting range on the fertility of the patients and the pregnancy outcome.To explore the pregnancy outcome of the laparoscopic cervico-isthmic cerclage with the history of cervical conization and further discusses the value of the prophylactic laparoscopic cervico-isthmic cerclage.Methods158 cases of patients with fertility requirements were choose out from 655 patients with cervical conization in January 2010 to December 2014 in Qilu Hospital of Shandong University to follow up.58 cases of the patients with the conization organization cone height is greater than 2.0 cm or the volume is greater than 4cm3 as the large cone cutter group,the average age of this group is 32 years (X=32.4±4.9, M=32),100 cases of patients with conization organization cone height≤2.0cm or cutting volume≤4cm3 as the small cone cutter group,the average age of this group is 33 years(X=33.7 ±3.9, M=33). Patients of the 58 cases who underwent prophylactic laparoscopic cervical cerclage were selection to be the cerclage group,and the other 36 patients were the non-cercalge group. Three group of patients with pregnancy history, pregnancy outcomes、 perinatal period of newborn and so on were analyzed retrospectively.The statistical method:using SPSS 17.0 statistical software for statistical analysis, measurement data are compared using t test, count data using x2 test, with P<0.05 as the difference has statistical significance, some statistical index were analysis OR.Results(1) the general situation and pregnancy:three groups of patients with no statistical difference (P>0.05). In the cerclage group of 22 patients, received a total of 19 times of pregnancy, the pregnancy rate was 86.4%(19/22); In the non-cerclage group of 36 patients, received a total of 30 times of pregnancy, pregnancy rate was 83.3%(30/ 36); the control group of 100 patients received a total of 88 times pregnancy and pregnancy rate was 88.0%(88/100). compared the three groups of pregnancy rate, the difference was not statistically significant (P> 0.05).(2) Pregnancy outcome:non-cerclage group and control group were compared, the preterm birth (gestational age<37W) rate of non-cerclage group patients were significantly increased, and the difference was statistically significant (OR:3.6, 95%CI:[1.2-10.8], P=0.017); the incidence of abortion、 preterm premature rupture of membranes and small gestational age infants were increased when compared with the control group, but the difference was not statistically significant (OR:1.58,95%CI: [0.53-4.67], P>0.05)、 (OR:1.7,95%CI:[0.58-5.39], P>0.05) and (OR:2.4, 95%CI:[0.75-7.66], P>0.05);(3) In perinatal period outcome:cerclage group compared with the non-cerclage group, the newborns with low birth weight infants, NICU, RDS and neonatal complications occurred rate was lower than that of non-cerclage group (OR:0.37, 95%CI:[0.07-2.12], P>0.05K (OR:0.176,95%CI:[0.02-1.62], P>0.05), (OR:0.224, 95%CI:[0.02-2.11], P>0.05). (OR:0.294,95%CI:[0.03-2.89], P>0.05)ConclusionsCervical conization had no significant effect to the patient’s fertility,but large cone cutter can make the incidence rate of premature delivery increased. The patients with history of large conization who have fertility requirements should better consider taking prophylactic laparoscopic cerclage to prevent cervical incompetence, reduce the incidence of premature birth and improve the perinatal prognosis.