Clinical Observation On Diagnosis And Treatment Of Cervical Incompetence In Twin Pregnancy

Objective:To investigate the clinical significance of diagnosis and treatment of cervical incompetence in twin pregnancies.Methods:A retrospective analysis of our hospital in January 2013-2016 year in October the hospital delivery in 352 cases of twin pregnancies,161 cases of assisted reproductive technology(including 113 cases of ovulation induction,48 cases of IVF),191 cases of natural conception,average age(30.27 ± 4.56)years old,of which 30 cases were diagnosed with cervical incompetence,21 cases with 2-5 times of high risk factors of mid pregnancy abortion and premature delivery,McDonald cervical cerclage was performed on22 cases of cervical incompetence,follow up and observe the incidence of cervical insufficiency and the comparison of different groups to prolong the gestational age.Results:The incidence of cervical incompetence in women with twin pregnancies with assisted reproductive technology[13.66%(22/161)and 4.19%(8/191),=10.062,P=0.002]was higher than that of natural pregnancy.22 cases of patients with cervical cerclage were prolonged gestational weeks [(15.27± 6.79)and(2.79 ± 5.75)weeks,t=4.619,P < 0.001]than 8 cases of patients with expectant treament and high rate of live births(81.82%).20 weeks after cervical cerclage with prolongation of gestation [(16.75 ± 6.27)and(8.75±4.20)weeks,t=-7.320,P < 0.001] more than 20 weeks pregnant patients underwentcervical cerclage.The prevention of patients with cervical cerclage of prolongation of gestation [(19.36 ± 3.61)and(8.13 ± 4.73)weeks,t=6.276,P < 0.001](19.36 ± 3.61)higher than that of patients with emergency cerclage(8.13 ± 4.73).In the elective cerclage group,these women who were cerclaged before 20 thgestation week[(16.75±6.27)and(8.75±4.20)weeks,t=-7.320,P < 0.001],could get longer gestational weeks than the women who were cerclaged after 20 thgestation week.An elective cerclage could get longer gestational weeks[(19.36±3.61)and(8.13±4.73)weeks,t=6.276,P < 0.001] than emergency cerclage.Conclusions:The cervical incompetence incidence rate in assisted reproductive technology of twin pregnancies group was higher than that in naturally conceived twin pregnancies group.The cervical cerclage of choosing the appropriate timing of surgery and weeks of gestation can prolong gestational age in patients with cervical incompetence for twin pregnancies,is beneficial to improve the outcome of pregnancy.