Analysis Of Pregnancy Outcomes And Treatments In Patients With The Cervical Insufficiency

Objective:to explore the effect of different therapies and different operation time on pregnancy outcomes in pregnant women with cervical insufficiency.Materials and methods:1.Data collection:a total of 48 cases with insufficiency of cervical insufficiency in gynecology and obstetrics of the first affiliated hospital of fujian medical university from January 2012 to December 2017 were collected.all patients with cervical insufficiency age range for 18 to 40 years old,with an average age of 29.40+5.03 years,32 cases were primipara,multipara in 16 cases,pregnancy found 17 cases cervical insufficiency,found that the cervical pregnancy insufficiency of 31 cases.Methods:conservative treatment?including intravenous drip,vaginal contractions inhibitors set,vaginal contractions inhibitors such as pessary non-surgical methods?,surgery?cervical cerclage:McDonald operation?,drug combination therapy+operation.According to the different treatment methods,48 cases were divided into:untreated group?A1 group,n=8?,conservative treatment group?A2 group,n=14?,surgical treatment group?A3 group,n=11?,combined treatment group?A4 group,n=15?.According to the different operation period,26 cases were divided into pre-pregnancy preventive cervical ring group?B1 group,n=2?,elective cervical ring ligation group?B2 group,n=20?,and emergency cervical ring group?B3 group,n=4?during pregnancy.The correlation between cervical insufficiency and age,history of pregnancy and surgical history was analyzed.The statistical method was illustrated by Excel2003.Use mean,percentage and standard deviation to represent statistics;The SPSS17.0 software was used to?2test,t test and Fisher exact probability test,and P<0.05 indicated that the difference was statistically significant.Results:1.The age range of 48 patients with cervical insufficiency was 18 to 40 years old,with an average age of 29.40+5.03 years,and the incidence of cervical insufficiency was younger.Of the 48 women with cervical insufficiency,31 of them had primary parturient,17 of them were born,and the uterine cervical function was not increased.Of the 48 cases of cervical insufficiency,52.1%of pregnant women with two or more miscarriages had a higher incidence of cervical insufficiency in pregnant women who had had multiple miscarriages.2.Comparing different treatment abortion rate from high to low were not the treatment group?14.58%?>conservative treatment group?10.42%?>combined treatment group?4.17%?>surgical treatment group?2.08%?,premature birth rate from high to low were conservative treatment group?14.58%?>combined treatment group?10.42%?>surgical treatment group?8.33%?>no treatment group?2.08%?and term production rate from high to low were combined treatment group?16.67%?>surgical treatment group?10.42%?>conservative treatment group?4.17%?>no treatment group?2.08%?,pregnancy outcome caused by different treatments,compared to significant statistical significance difference??2=17.22,P=0.009<0.05?.Compare the condition of different treatments,the Apgar score 1minutes after birth??2=0.396,P=0.005<0.05?there are significant difference statistically significant.3.Compare the different period of cervical cerclage in extend gestational age,B1 group?average extend gestational age 33.00+2.83,n=2?,B2 group?average extend gestational age 15.29+7.87,n=20?,the B3 group?average extend gestational age 0.75+0.50,n=4?,pregnancy preventive or pregnancy line elective cervical cerclage in prolong the gestational age more significantly than emergency line cervical cerclage surgery during pregnancy,?t₀=13.78,P₀=13.78<0.05?,there are significant difference statistically significant.4.Comparing the effects of cervical ligation on pregnancy outcome in different periods,the percentage of miscarriages in the three groups was from high to low B3 group?11.54%?>B2 group?0.00%?=B1 group?0.00%?.Premature percentage from high to low were B2 group?26.92%?>B1 group?3.85%?=B3group?3.85%?and term to produce percentage from high to low were B2 group?50.00%?>B1?3.85%?>B3 group?0.00%?,cervical insufficiency in patients with preventive or elective cerclage in reducing miscarriage or premature birth,improve the term to produce better than emergency cerclage??²=31,P=0.00<0.05?,there are significant difference statistically significant.Conclusion:1.The use of cervix in the pregnant women with cervical insufficiency is more significant in prolongation of pregnancy than conservative treatment,and the combination of surgery and drugs has the best effect on the insufficiency of cervical insufficiency.2.Pre-pregnancy prophylactic cervix surgery is beneficial to reduce the late abortion and premature delivery,and increase the incidence of cervical insufficiency.Emergency cervical ligation treatment for cervical insufficiency is less effective in improving maternal and infant outcomes than in preventive cervix and elective cervix.3.Patients with cervical insufficiency can prolong pregnancy week,improve pregnancy outcome and improve neonatal condition by taking preventive hysterectomy or elective cervix?14 to 20 weeks?.4.Cervical insufficiency is associated with previous history of adverse pregnancy and delivery,and insufficient evidence is available for the correlation with age and pregnancy.Therefore,it is suggested that women with history of bad pregnancy and childbirth should be evaluated before pregnancy and during pregnancy.