The Analysis Of Clinical Outcomes Of Transvaginal Cervical Cerclage For Cervical Insufficiency

Objective: By a retrospective study of past cases to discuss the effectiveness and safety of transvaginal cervical cerclage,medical records of cervical insufficiency;Objective to investigate whether the indications of operation for pregnant women with cervical incompetence should be loose and the indications of transabdominal and transvaginal cerclage.Methods:1 We retrospectively observed the pregnancy outcome of 187 patients diagnosed with cervical insufficiency from January 2010 to September 2016 in the second Hospital of Hebei medical university.There were 111 cases leave in the research.2 The diagnosis of cervical insufficiency confirmed in pregnancy based on medical history,physical examination,auxiliary examination,among which medical history is the most important.According to The American College of Obstetricians and Gynecologists(ACOG)and the seventh edition of Gynecology and Obstetrics,consults the domestic and foreign literature,the diagnosis of the cervical insufficiency is conclude the following several points:? medical history: more than one mid-term miscarriage in pregnancy and preterm birth,without painful contractions;the surgical history of cervix;?physical examination: duration of pregnancy cervix is shorter than normal level via vaginal examination,cervical canal dilation,at the same time can observe the situation of cervix;? Transvaginal B-ultrasound shows cervix shortened to less than 25 mm or cervical canal expansion or cervical enlarged in the shape of funnel with bulging amniotic sac.The examine evidence of non-pregnant: ?No.8 Hegar dilator passed inside the mouth of cervix;?hysterosalpingography or hysteroscopy confirmed cervical insufficiency.With the above diagnostic criteria first,and in line with the other 4 in any of the 1confirmed.3 Using EXCEL software creates tables,organizing the medical records and conducting a preliminary statistical analysis.The data were statistically processed by SPSS 22.0 statistical software.P < 0.05 indicated significant difference.Results:In general cases 111 patients: the minimum age of 20 years,the maximum age 39 years,mean age 28.65 years,median age 28 years;has a history of mid-term miscarriage or premature birth is 22 cases,two history of mid-term miscarriage or premature birth is 46 cases,three history of mid-term miscarriage or premature birth is 43 cases,the average pregnancy is 3.52 times,median pregnancy is 3 times;the minimum gestational age is 12+1,the maximum gestational age is 24+3,the average gestational age is 16.11,median gestational age is 15+4.Conclusions:1 the diagnosis and surgical indications of cervical insufficiency are for further specification.In accordance with the diagnostic criteria for cervical insufficiency,cervical cerclage can effectively improve the pregnancy outcomes.Cervical cerclage is a safe and effective treatment for cervical insufficiency.2 The operation indication of cervical insufficiency should be loose.3 The choice of operative approach: youth and fertility may preferred transvaginal cervical cerclage;elderly,preciousson,vaginal surgery is difficult,not suitable for transvaginal cervical cerclage even because of infertility for assisted reproduction may be preferred for Laparoscopic cervical cerclage.