Evaluation of effectiveness of prophylactic cerclage of a short cervix according to interleukin-8 in cervical mucus
Evaluation of effectiveness of prophylactic cerclage of a short cervix according to interleukin-8 in cervical mucus
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DOI：
10.1016/j.ajog.2005.06.014
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发表时间：
2006-01-01
影响因子：
9.8
通讯作者：
Saito, S
中科院分区：
文献类型：
--
作者：
Sakai, M;Shiozaki, A;Saito, S
目的：本研究是进行比较早产率根据宫颈粘液白细胞介素-8（IL-8）的妇女谁接受环扎术，因为一个短cervice.Study design：这项回顾性研究包括16,508例患者的宫颈长度和宫颈粘液IL-8浓度测定20和24周之间。短宫颈定义为长度为25 mm或更短，而IL-8浓度超过360 ng/mL被认为是高的。是否进行环扎术由临床医生决定，而不考虑IL-8 concentration.Results：在所有受试者中，当宫颈粘液IL-8升高（P = 0.0302）或宫颈短（P <0.0001）时，37周前避免分娩的受试者百分比显著较小。在宫颈短的患者中，当宫颈粘液IL-8升高时，早产的可能性更大。总的来说，短宫颈患者早产的风险在接受环扎术和未接受环扎术的患者之间没有差异。然而，在宫颈短的患者中，如果接受环扎术，宫颈粘液中IL-8浓度正常的患者发生早产的可能性较小（37周前，33% vs 54.5%，P = 0.01; 34周前，4% vs 13.6%，P = 0.03）。相反，当宫颈粘液IL-8高时，37周前分娩的可能性高于不环扎术（78% vs 54.1%，P = 0.03）。结论：宫颈粘液IL-8正常时，宫颈缩短的环扎术治疗可降低早产率，但宫颈粘液IL-8升高时，环扎术可能有害。(c)2006 Mosby，Inc. All rights reserved.
Objective: This Study was undertaken to compare rates of preterm delivery according to cervical mucus interleukin-8 (IL-8) among women who underwent cerclage because of a short cervix.Study design: This retrospective Study included 16,508 patients whose cervical length and cervical mucus IL-8 concentrations were measured between 20 and 24 weeks. A short cervix was defined by a length of 25 mm or less, whereas IL-8 concentrations exceeding 360 ng/mL were considered high. Whether to perform cerclage was decided by clinicians without consideration of IL-8 concentrations.Results: Among all subjects, a significantly smaller percentage of subjects avoided delivery before 37 weeks when cervical Mucus IL-8 was elevated (P = .0302) or the cervix was short (P < .0001). Among patients with a short cervix, preterm delivery was more likely when cervical mucus IL-8 was elevated. Overall, risk of preterm delivery in patients with a short cervix did not differ between those undergoing and not undergoing cerclage. However, among patients with a short cervix, those with normal IL-8 concentrations in cervical mucus were less likely to have preterm delivery if they underwent cerclage (before 37 weeks, 33% vs 54.5%, P = .01; before 34 weeks, 4% vs 13.6%, P = .03). In contrast, when cervical mucus IL-8 was high, delivery before 37 weeks was more likely with than without cerclage (78% vs 54.1 %, P = .03).Conclusion: With normal cervical mucus IL-8, cerclage treatment for cervical shortening may reduce the rate of preterm delivery, but with elevated cervical mucus IL-8 cerclage may be harmful. (c) 2006 Mosby, Inc. All rights reserved.