Analysis Of Clinical Data Of 78 Cases With Modified Shirodkar Cervical Cerclage

Objective:To explore the safety and effectiveness of modified Shirodkar cervical cerclage in the treatment of cervical insufficiency during pregnancy,and to discuss the etiology,treatment,pregnancy management,complications,neonatal weight Apgar score and delivery methods of cervical insufficiency.Methods: A retrospective analysis was performed on 78 pregnant women who were admitted to the obstetrics department in the east Campus of the second hospital of hebei medical university from April 2013 to August 2019 and received the modified Shirodkar cervical cerclage.Results: 1.Among the 78 cases,60 cases?76.9%?had full-term birth,12 cases?15.4%,among which 4 cases were delivered at 28-32 weeks and 8 cases were delivered at 32-37 weeks?had a premature labor,and 6 cases?7.7%?suffered a miscarriage.The rate of live birth reached 92.3%,among which 71 newborns?1 minute?score of Apgar score was greater than or equal to 7 points,a newborn was less than 7 points.37 cases?51.4%?were delivered by vaginal delivery,and 35 cases?48.6%?were delivered by cesarean section.Modified Shirodkar cervical cerclage for patients with indications can significantly improve the rate of full-term and live birth,and has a significant effect on the treatment of cervical insufficiency.2.Among the 78 patients with cervical insufficiency,there were 54?69.2%?with polycystic ovary syndrome,32?41%?patients with gestational diabetes melilitus and 8?10.3%?patients with pregestational diabetes melilitus,21?26.9%?patients with subclinical hypothyroidism,and 5?6.5%?patients with hypertensive disorders of pregnancy.Compared with the prevalence of pregnant women in China,the incidence of polycystic ovary syndrome,gestational diabetes melilitus and subclinical hypothyroidism is increased,and there is no significant difference in the incidence ofhypertensive disorders of pregnancy.3.The operative conditions of 78 patients showed no spontaneous rupture of membranes during the operation,the average operative time was 35.8±4.0min,and the average intraoperative bleeding was 20.8±6.9ml,with no significant postoperative complications.4.The gestational weeks of delivery?37±3.2 weeks?,the acquisition rate of live babies?93.1%?,and the average weight of newborn?3080±485g?of prophylactic cervical cerclage?72 cases?were all higher than the gestational weeks of delivery?33±6.5 weeks?,the acquisition rate of live babies?83.3%?,and the average weight of newborn?2450±685g?of therapeutic cervical cerclage?6 cases?,with statistically significant differences?P<0.05?.Among 72 cases of prophylactic cervical cerclage,59 cases underwent cervical cerclage at 12⁺³-17⁺⁶ weeks of pregnancy,and 13 cases underwent cervical cerclage at 18-24 weeks of pregnancy.The gestational weeks?37.2±3.2weeks?and the live baby acquisition rate?93.2%?at the 12⁺³-17⁺⁶ weeks of cervical cerclage group were all higher than the gestational weeks?37±3.0weeks?and the live baby acquisition rate?84.6%?at the 18-24 weeks of cervical cerclage group,but there is no significant difference?P >0.05?.Conclusion:Cervical cerclage is an effective surgical intervention for the treatment of cervical insufficiency,and modified Shirodkar cervical cerclage can effectively improve pregnancy outcome in patients with indications.