Analysis Of Clinical Data Of 111 Patients With Modified Mc Donald’s Cervical Cerclage

Objective:To investigate the advantages of modified McDonald’s cervical cerclage on patients of CI during pregnancy and postpartum,and to discuss the etiology,treatment,intrapartum management,complications in pregnancy and delivery modes of patients with CI.Methods :Pregnant women admitted to the Department of Obstetrics of the First Affiliated Hospital of Shanxi Medical University from July 2013 to June 2017 were reviewed.A retrospective study was conducted on 111 cases of single fetal pregnancy with CI who underwent modified McDonald’s cervical cerclage in our hospital.Results:(1)The BMI for 111 patients with CI before pregnancy:the average was 23.7 ± 3.2kg/m2,28 cases were over 24 kg/m2,and 11 cases were over 28 kg/m2.It indicates that BMI of the patients with CI before pregancy are relatively large and the average level is close to overweight.(2)Among 111 patients with CI and cervical cerclage,83 cases(74.8%)had full-term birth,20 cases(18%)had a premature labor and 8 cases(8.2%)had a miscarriage.92.8%of the patients had alive newborn with the average birth weight 3008±636g.The modified McDonald’s cervical cerclage can increase the patient’s full-term birth rate and live birth rate and has good advantages on the treatment of CI.(3)History-indicated cerclage is better than ultrasound-indicated cerclage on weeks ofdelivery,average extend gestational age,live birth rate,and average birth weight,and the differences were statistically significant(P<0.05).(4)Among the live-birth patients,63 cases(61.2%)delivered by vaginal,including 15 cases with cervical laceration;40 cases(38.8%)delivered by cesarean section.The main causes of cesarean section were the abnormal fetal position,social factors,obstetric complications,fetal distress,scar uterus,macrosomia,cephalopelvic disproportion and abnormal labor.Cervical cerclage had no significant effect on the mode of delivery,but the cervical laceration rate was higher in patients with cervical cerclage.(5)Among 111 patients with CI,there were 49 cases with diabetes mellitus of which 46 cases were gestational diabetes mellitus,and there were 27 cases with subclinical hypothyroidism during pregnancy.Compared with the prevalence of GDM and subclinical hypoplasia during pregnancy in China,the prevalence of these increased significantly in patients with CI.Conclusion:Cervical cerclage is an effective intervention for the treatment of CI.The modified McDonald’s Cervical cerclage for patients with indications can effectively prolong gestational age and increase the full-term birth rate and live birth rate.