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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >Infant outcomes following midtrimester emergency cerclage in the presence of fully dilated cervix and prolapsing amniotic membranes into the vagina
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Infant outcomes following midtrimester emergency cerclage in the presence of fully dilated cervix and prolapsing amniotic membranes into the vagina

机译：子宫颈中期完全扩张和羊膜向阴道内扩张时，在妊娠中期紧急环扎后的婴儿结局

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Objective: To investigate the morbidity of infants, whose delivery was prolonged by an emergency cervical cerclage (EC).Methods: Ante- and postnatal data on subsequent EC procedures performed between 14 and 28 weeks of gestation for advanced cervical dilatation with prolapsing of amniotic membranes at a single institution within a 5-year-period were retrieved.Results: We identified 21 fetuses from 18 pregnancies. Median gestational age [interquartile range, IQR] at EC and prolongation of pregnancy was 21.5 [15-26] weeks and 49.3 [24-92] days, respectively. There were 4 (19%) stillbirths, 3 (14%) neonatal deaths, and 1 (5%) infant death. Ten infants (59% of livebirths) were admitted to neonatal intensive care unit and hospitalized for a median period of 11 [6-66] d. Of the surviving fetuses (14/21, 66.7%), 9 (42.8%) were intact, whereas 3 (17.6% of livebirths) had cerebral palsy (CP), 1 was diagnosed with hypothyroidism, and another had growth failure at 12 months of follow-up.Conclusion: EC seems to be beneficial only in a subset of pregnancies presenting with full cervical dilatation accompanied by prolapsing amniotic membranes into the vagina, and there is a requirement for more objective selection criteria. Neonatal morbidity, especially neurodevelopmental disability should be discussed thoroughly prior to this procedure.
机译：目的：探讨通过紧急宫颈环扎术（EC）延长分娩时间的婴儿的发病率。方法：妊娠和产后数据，对妊娠14至28周后进行的妊娠晚期宫颈扩张并伴有羊膜扩张的EC手术进行分析。结果：我们从18个怀孕中鉴定出21个胎儿。 EC的中位胎龄[四分位间距，IQR]和妊娠延长分别为21.5 [15-26]周和49.3 [24-92]天。有4（19％）个死产，3（14％）新生儿死亡，和1（5％）婴儿死亡。 10名婴儿（占分娩的59％）入院了新生儿重症监护室，住院时间中位数为11 [6-66] d。在存活的胎儿中（14/21，66.7％），完整的有9名（42.8％），而脑瘫（CP）的有3名（占分娩的17.6％），诊断为甲状腺功能减退的有1名，而在12个月时又有生长衰竭结论：EC似乎仅对子宫颈完全扩张并伴有羊膜进入阴道的部分妊娠有益，因此需要更客观的选择标准。新生儿发病率，尤其是神经发育障碍应在此程序之前进行彻底讨论。

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