UNASSIGNED: A multicenter, retrospective, cohort study was conducted at 10 tertiary centers using a web-based data collection platform. The study population included twin pregnancies delivered after 20 weeks of gestation. Patients with one or two fetal deaths before 20 weeks of gestation were excluded. Maternal characteristics, including prenatal cervical length (CL) and obstetric outcomes, were retrieved from the electronic medical records.
UNASSIGNED: A total of 1,473 patients had available data regarding the CL measured before 24 weeks of gestation. Seven patients without CL data obtained prior to cerclage were excluded from the analysis. The study population was divided into two groups according to the CL measured during the mid-trimester: the CL ≤2.5 cm group (n = 127) and the CL >2.5 cm group (n = 1,339). A total of 127 patients (8.7%) were included in the CL ≤2.5 cm group, including 41.7% (53/127) who received cerclage. Patients in the CL >2.5 cm group who received cerclage had significantly lower gestational age at delivery than the control group (hazard ratio (HR): 1.8; 95% confidence interval (CI): 1.11-2.87; p = .016). Patients in the CL ≤2.5 cm group who received cerclage had a significantly higher gestational age at delivery than the control group (HR: 0.5; 95% CI: 0.30-0.82; p value = .006).
UNASSIGNED: In twin pregnancies with a CL ≤2.5 cm, cerclage significantly prolongs gestation. However, unnecessary cerclage in women with a CL >2.5 cm may result in a higher risk of preterm labor and histologic chorioamnionitis although this study has a limitation originated from retrospective design.
■一个多中心,回顾性,队列研究使用基于网络的数据收集平台在10个三级中心进行.研究人群包括妊娠20周后分娩的双胎妊娠。在妊娠20周前有一个或两个胎儿死亡的患者被排除在外。产妇特征,包括产前宫颈长度(CL)和产科结局,是从电子病历中找到的.
■共有1,473名患者在妊娠24周前有关于CL测量的可用数据。从分析中排除了在环扎之前没有获得CL数据的7例患者。根据中期测量的CL将研究人群分为两组:CL≤2.5cm组(n=127)和CL>2.5cm组(n=1,339)。CL≤2.5cm组共纳入127例患者(8.7%),包括41.7%(53/127)接受环扎的人。CL>2.5cm组接受环扎术的患者分娩时孕龄明显低于对照组(风险比(HR):1.8;95%置信区间(CI):1.11-2.87;p=0.016)。CL≤2.5cm组接受环扎术的患者分娩时孕龄明显高于对照组(HR:0.5;95%CI:0.30-0.82;p值=.006)。
■在CL≤2.5cm的双胎妊娠中,环扎术显著延长妊娠。然而,CL>2.5cm的女性不必要的环扎可能会导致早产和组织学绒毛膜羊膜炎的风险更高,尽管这项研究的局限性在于回顾性设计.