[Antibiotic administration as a treatment of cervical insufficiency with intra-amniotic infection/inflammation?]

Analysis of the Timing of Cervical Cerclage Treatment in Pregnant Women with Cervical Insufficiency and the Effect on Pregnancy Outcome

Purpose

To analyze the effect of the choice of timing of cervical cerclage treatment on pregnancy outcome in pregnant women with cervical insufficiency (CI).

Methods

The case data of 160 pregnant women admitted to our hospital for cervical cerclage due to CI from January 2020 to September 2021 were sampled. They were divided into the early group (14∼18 weeks of pregnancy, n = 86), the middle group (19∼27 weeks of pregnancy, n = 74) according to the different gestational periods of surgical treatment, and into the elective group (elective operation, n = 71) and the emergency group (emergency operation, n = 89) according to the different timings of surgical treatment. To compare the pregnancy outcomes of the four groups and the effects of different treatment timings on pregnant women and newborns.

Results

After the operation, the intrauterine infection rate in the early group was lower (8.14% (7/86)) than that (71.62% (53/74)) in the middle group, and the intrauterine infection rate (18.31% (13/71)) in the elective group was lower (61.80% (55/89)) than that in the emergency group (P < 0.05). After the operation, the late abortion rate in the early group was 8.14% (7/86) lower than 63.51% (47/74) in the middle group, and the late abortion rate in the elective group was 15.49% (11/71) lower than 61.80% (55/89) in the emergency group (P < 0.05). After the operation, the full-term birth rate (82.56% (71/86)) in the early group was higher (21.62% (16/74)) than that in the middle group, and the full-term birth rate (73.24% (52/71)) of the elective group was higher (24.72% (22/89)) than that in the emergency group (P < 0.05). After the operation, there was no significant difference in the preterm birth rate between the early group and the middle group (8.14% vs 14.86%), and between the elective group and the emergency group (11.27% vs 12.36%) (P > 0.05). There was no significant difference in neonatal Apgar scores between the early group and the middle group (7.30 ± 0.98 vs 7.14 ± 0.91) scores, and between the selective group and the emergency group (7.15 ± 0.82 vs 7.07 ± 1.07) scores (P > 0.05). There was no significant difference in gestational week extension time between the early group and the middle group (6.52 ± 1.77 vs 6.99 ± 1.69) days and between the elective group and the emergency group (6.44 ± 1.37 vs 6.82 ± 1.70) days (P > 0.05). The length of hospital stay was (7.28 ± 1.39 vs 10.89 ± 2.65) days in the early group and the middle group, with the early group being shorter than the middle group (P < 0.05), and the length of hospital stay was (8.72 ± 1.23 vs 9.30 ± 1.39) days in the elective group and the emergency group, with the elective group being shorter than the emergency group (P < 0.05).

Conclusions

The therapeutic effect and pregnancy outcome of cervical cerclage are affected by the timing of treatment. Among them, the effect of elective operation at 14∼18 weeks of pregnancy is more ideal, which is worthy of clinical promotion.