Clinical Analysis Of Two Different Cervical Cerclage Methods For Cervical Incompetence Before Pregnancy

Objective By comparing the pre-pregnancy modified Shirodkar cervical cerclage and pre-pregnancy laparoscopic cervical cerclage for the treatment of cervical incompetence,To investigate the clinical value of pre-pregnancy modified Shirodkar cervical cerclage in the treatment of cervical incompetence.Methods We retrospectively analyzed 61 patients who met the inclusion and exclusion criteria from January 2015 to June 2016 in the Liuzhou Maternal and Child Health Hospital.Divided according to different surgical methods: Pre-pregnancy modified Shirodkar cervical cerclage group(VCC group)28 cases,pre-pregnancy laparoscopic cervical cerclage group(LCC group)33 cases,from the duration of surgery,intraoperative blood loss,surgery Complications,total length of hospital stay,pregnancy outcomes,neonatal birth weight,and neonatal health(survival or death)evaluated the effectiveness and safety of the two surgical procedures in the clinical treatment of cervical incompetence.Result1.Comparison of the general situation of the two patients: Age,body mass index,white blood cell count,number of abortions in the previous middle and late pregnancy,and number of births in both groups were not statistically significant(P> 0.05).2.Comparison of intraoperative conditions between the two groups: Two groups of patients during:One patient in the LCC group had a slight bladder injury and had surgical sutures.There was no discomfort postoperatively.In the VCC group,the surgical procedure was smooth and no complications occurred during the operation.One postoperative incision infection occurred,one incision failed to heal,and one surgical incision oozing occurred.There was no significant difference in the postoperative complications between the two groups(P< 0.05).There was no significant difference in the operation time,intraoperative blood loss and length of hospital stay between the two groups(P>0.05).3.Comparison of pregnancy outcomes in the two groups: 28 patients in the VCC group were naturally conceiving(single fetus),the post-operative pregnancy rate was 100%,32 cases of spontaneous conceiving(single fetus)in the LCC group,and one was not conceived due to short pregnancy preparation time and insufficient follow-up time,postoperative pregnancy rate 97.0%,no significant difference between the two groups after the comparison;postoperative miscarriage,surgical success,postoperative preterm birth,full-term pregnancy,total number of days of pregnancy,neonatal survival and newborn weight The difference was not statistically significant(P>0.05);4 cases(14.3%)in the VCC group were delivered by caesarean section because of abnormal fetal position and 32 cases(100%)in the LCC group had undergone caesarean section delivery.There were statistical differences between the two groups.Significance(P<0.05).Conclusion1.Pre-pregnancy modified Shirodkar cervical cerclage and pre-pregnancy laparoscopic cervical cerclage have similar effects on pregnancy outcomes in patients with cervical insufficiency,but The detachment of the cerclage band is easier after the improved Shirodkar cervical cerclage,lower medical costs,and can be performed after surgery By vaginal delivery,the modified Shirodkar cervical cerclage is more advantageous;2.Pre-pregnancy cervical cerclage treatment of cervical insufficiency is safe and reliable,and the surgical skills are easy to grasp and worthy of clinical application.