Abstract
Objective: To analyze the clinical characteristics and pregnancy outcomes of 184 pregnant women with cervical insufficiency (CI) who underwent transvaginal cervical cerclage (TVC) surgery, and to evaluate its effectiveness and clinical significance.
Method: A retrospective analysis was conducted on the case data of 184 pregnant women who underwent vaginal cervical cerclage from January 2017 to December 2023, including gestational age, gestational frequency, parity, cerclage time, cervical length before cerclage, extended gestational weeks after cerclage, pregnancy outcome, and newborn condition. Firstly, based on the cervical length at the time of cerclage, they were divided into a<2.0cm group (64 cases) and a ≥ 2.0cm group (83 cases); According to the timing of cervical cerclage surgery, 102 cases were divided into a scheduled group (including 44 cases of preventive cerclage and 58 cases of therapeutic cerclage) and an emergency group of 82 cases; The selective cervical cerclage group was divided into an early group (cervical cerclage performed at 9-16 weeks) of 44 cases and an advanced group (cervical cerclage performed at 16-24 weeks) of 45 cases based on the number of cycles of cerclage. The clinical characteristics of this disease were analyzed and summarized.
Result: The gestational age, extended gestational age, newborn body weight, and newborn Apgar score (1 and 5 minutes) of the group with cervical length ≥ 2.0cm during cerclage were significantly higher than those of the<2.0cm group, while the gestational age during cerclage was significantly lower than that of the<2.0cm group, with statistical significance (P<0.05 for all). There were statistically significant differences (P<0.05) in the cervical length during cerclage, gestational weeks during cerclage, extended gestational weeks, full-term delivery rate, newborn birth weight, 1-minute Apgar score, and 5-minute Apgar score between the prevention group and the emergency group of pregnant women. There was no statistically significant difference in the extended gestational week, delivery gestational week, delivery blood volume, newborn birth weight, fetal survival rate, cesarean section delivery rate, newborn 1-minute Apgar score, and newborn 5-minute Apgar score between the early group (12-16 weeks, 44 cases) and the late group (16-24 weeks, 55 cases).
Conclusion: Pregnant women with a cervical length of ≥ 2.0cm during cerclage have better pregnancy outcomes than those with a cervical length of<2.0cm; Preventive cervical cerclage can improve the rate of full-term delivery and fetal survival; Emergency cerclage is a feasible remedial measure; Transvaginal cervical cerclage at 16-25 weeks of pregnancy can be an effective method to prolong pregnancy time.