Analysis Of Related Factors Of Pregnancy Outcomes In509 Patients With Cervical Insufficiency After Cervical Cerclage

Objective:To investigate the correlation between the possible factors related to the occurrence of cervical insufficiency and the pregnancy outcome of patients with cervical insufficiency after cervical cerclage treatment,and to increase the vigilance of such patients to achieve the expected clinical outcome.Methods: 509 patients with cervical insufficiency who were treated with cervical cerclage from January 2015 to December 2018 was divided into three levels: all patients who received cervical cerclage(n = 509),patients undergoing Traditional vaginal cerclage(TVC;n = 466),patients undergoing laparoscopic cervical cerclage(n = 43).There are 13 factors including ovulation promotion,assisted reproductive technology(ART),and infertility et al.Using the gestational gestation week as the end point of observation,the COX proportional hazard model was used to analyze the pregnancy outcomes of patients at three levels.Results:1)Surgical route(RR = 3.753,95% CI: 1.916,7.352),number of gestational fetuses(RR = 0.538,95% CI: 0.337,0.859),the number of induced labor in the second and third trimester(RR = 0.529,95% CI: 0.364,0.769)And whether pregnancy combined with assisted reproductive technology(RR = 0.598,95% CI: 0.426,0.838)had statistically significant association with the pregnancy outcome of patients with cervical insufficiency after cervical cerclage treatment(P <0.05).2)Preventive or emergency cervical cerclage(RR = 0.608,95% CI: 0.460,0.804),emergency or subacute cervical cerclage(RR = 2.087,95% CI: 1.298,3.356),the number of induced labor in the second and third trimester = 0.526,95% CI: 0.357,0.776)and whether pregnancy with assisted reproductive technology(RR = 0.608,95% CI: 0.430,0.860)was statistically significant(P <0.05)).3)Age,single / twin twins,the number of induced labor in the second and third trimesters,whether there is a history of full-term delivery before this pregnancy,history of cervical conization before cerclage,congenital uterine malformation,polycystic ovary syndrome,drainage,assisted reproduction technology ART),the potential for pelvic organ prolapse,and the association between infertility and pregnancy outcome after CNL treatment(P> 0.05).Conclusion:(1)Pregnancy combined with assisted reproductive technology,twin pregnancies,and more than 2 inductions in the second and third trimester have adverse effects on the pregnancy outcome of patients with cervical insufficiency after cervical cerclage treatment;(2)Compared with emergency cerclage,preventive cerclage has a higher pregnancy success rate at 37 weeks;compared with emergency cerclage,subacute cerclage has a higher pregnancy success rate at 37 weeks;(3)compared with TVC treatment,CNL treatment The gestational age of the patient was significantly prolonged;the 37-week pregnancy success rate of the CNL treatment group was significantly higher than that of the TVC treatment group.