Effect Of Cervical Cerclage For Cervical Insufficiency On Pregnancy Outcome

Objective:To compare the pregnancy outcomes of transvaginal cervical cerclage and conservative treatment in patients with cervical insufficiency,and to explore the efficacy and feasibility of cervical cerclage in the treatment of cervical insufficiency.Methods:Sixty patients with cervical insufficiency who visited our hospital from June2018 to March 2020 were selected.The patients were divided into observation group(n = 30)and control group(n = 30)according to the operation indications and informed consent of patients and their families.Patients in the observation group were treated with transvaginal cervical loop ligation,and those in the control group were treated conservatively(expectant management).The pregnancy outcomes,including pregnancy success rate,abortion,premature delivery rate and neonatal conditions,were compared between the two groups.Complications during pregnancy were compared between the two groups.Results:30 patients in the observation group were successfully completed the operation,with a success rate of 100.00%.The average surgical duration was 52.56 ± 9.35 min,and the intra-operative hemorrhagic volume was20.24 ± 2.06 m L.No serious complications were observed during the operation and the average hospital stay was5.4 ± 0.73 days.The comparison of pregnancy outcomes between the two groups showed that the average delivery time in the observation group was 37.7 ± 1.9 weeks,significantly longer than that in the control group(36.5 ± 2.5 weeks)(P <0.05).Compared with the control group,the abortion rate(3.33% vs 23.33%)and premature delivery rate(0.00% vs 34.78%)in the observation group were significantly reduced,while the pregnancy success rate(96.67% vs 76.67%)and full-term delivery rate(100.00% vs 65.22%)were significantly different(P <0.05).The comparison of neonatal conditions between the two groups showed that compared with the control group,the neonatal weight [(3.14 ± 0.45 kg)vs(2.84 ±0.48 kg)] and 1-minute Apgar score [(9.38 ± 1.16)vs(8.02 ± 1.08)] in the observation group were significantly higher,and the proportion of underweight newborns(3.45%vs 26.09%)was significantly lower than that in the control group,with statistically significant differences(P < 0.05).The neonatal survival rate in the observation group(100% vs 86.96%)was also significantly higher than that in the control group(P <0.05).The comparison of pregnancy complications between the two groups showed that the incidence rate of fetal membrane in the observation group(3.33% vs 20.00%)was significantly lower than that in the control group,and the difference had statistical significance(P < 0.05).Conclusion:The results of this randomized controlled group study showed that transvaginal cervical loop ligation has a higher efficacy in the treatment of cervical insufficiency compared with conservative treatment,which can significantly improve the pregnancy outcomes such as term delivery rate of pregnancy success rate,and improve the neonatal outcomes,with a higher surgical safety.