Management of cervical weakness based on the measurement of cervical resistance index
Management of cervical weakness based on the measurement of cervical resistance index
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DOI：
10.1016/j.ejogrb.2006.10.006
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发表时间：
2007-10-01
期刊：
影响因子：
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通讯作者：
Calder, Andrew A.
中科院分区：
文献类型：
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作者：
Anthony, George S.;Walker, Robert G.;Calder, Andrew A.
目的：评估测量宫颈阻力指数 (CRI) 的价值，以帮助选择有妊娠中期自然流产史的患者，以便在随后的妊娠中进行宫颈环扎术。研究设计：一项观察性研究，对象为 175 名有一次或多次妊娠中期自然流产史的患者，以及 123 名在常规妊娠期间进行了 CRI 测量的非孕妇。 妇科手术。对于那些 CRI 表明宫颈机能不全的女性，建议在未来妊娠时进行宫颈环扎术，而 CRI 正常的女性则建议进行保守治疗，而不进行环扎术。结果：123 名对照女性的中位 CRI 为 38.26 N，而研究组的中位 CRI 为 17.00 N。在 175 名研究女性中，有 62 名 (35%) 的 CRI 结果与既往病史不一致。 中期妊娠损失； 30 名 (16.6%) 被认为 CRI 能力强，而病史显示无能力，32 名 (18.4%) 被认为 CRI 能力不强，而病史表明子宫颈应能力强。参与研究的 175 名女性曾有过 486 次妊娠，其中 27.4% 的妊娠结果成功。 94 名患者目前已怀孕 148 次，成功率达 75.8%。结论：有孕中期自然流产史的未怀孕女性的宫颈阻力指数显着低于未经历过孕中期流产的已产女性。 35% 的患者 CRI 与之前的损失史不一致。 CRI 可能是一种有用的技术，有助于诊断宫颈无力，从而可以合理选择预防性宫颈环扎术的治疗方案。 (C) 2006 Elsevier Ireland Ltd. 保留所有权利。
Objective: To assess the value of measuring cervical resistance index (CRI) as an aid to selecting patients with a history of spontaneous midtrimester miscarriage for cervical cerclage in subsequent pregnancies.Study design: An observational study of 175 patients with a history of one or more spontaneous mid-trimester losses and 123 non-pregnant women who had CRI measurements performed while undergoing routine gynaecological surgery. Those women whose CRI indicated an incompetent cervix were recommended for cervical cerclage in future pregnancies while women with a normal CRI were recommended for conservative management without cerclage.Results: The median CRI in the 123 control women was 38.26 N while the median CRI in the study group was 17.00 N. In 62 of the 175 study women (35%) the CRI findings were at variance with the history of previous mid-trimester loss; 30 (16.6%) were deemed competent on CRI whereas the history suggested incompetence and 32 (18.4%) were incompetent on CRI while the history suggested that the cervix should be competent. The 175 study women had had 486 previous pregnancies with a successful outcome in 27.4% of the pregnancies. Ninety-four patients have now had 148 pregnancies with a successful outcome in 75.8% of the pregnancies.Conclusions: Non-pregnant women with a history of spontaneous mid-trimester miscarriage have a significantly lower cervical resistance index than parous women who have not suffered mid-trimester loss. In 35% of patients the CRI was at variance with the history of the previous loss. CRI may be a useful technique to aid the diagnosis of cervical weakness allowing a rational selection for treatment with prophylactic cervical cerclage. (C) 2006 Elsevier Ireland Ltd. All rights reserved.