背景:由于辅助生殖技术,双胎妊娠的发生率在世界范围内呈上升趋势。宫颈扩张是常见的并发症,可以认为是双胎妊娠早产的原因。体外受精(IVF)双胞胎更容易早产。在双胞胎中,不建议使用正常宫颈长度的常规宫颈环扎术,但是没有对试管婴儿双胞胎进行研究。所以,本研究旨在评估宫颈长度正常的双胎IVF妊娠常规经阴道环扎术对母胎结局的影响。
方法:2016年1月至2019年12月在印度东部一家妇产医院进行了一项回顾性病例对照研究,分娩超过21800例。采取两组,病例是那些宫颈长度正常的IVF双胞胎,其中宫颈环扎术是由IVF中心转诊到我们医院进行的,而对照中没有进行宫颈环扎术,因为他们是从其他IVF中心转诊的,其中环扎术不是常规方案。我们排除了为历史做的环扎,超声显示,子宫异常,和单绒毛膜双胞胎.在病例和对照中招募了15名参与者。
结果:在我们的研究2(6.66%)中,4(13%),和26(86%)的试管婴儿双胞胎在<28周胎龄分娩,28-32周,32-37周,分别。参与者的平均年龄,分娩时的平均胎龄,病例和对照组的出生体重为35.27±5.98岁(min:23;max:45),32.40±5.54年(最小:25;最大:44);34周2天±3.28(最小:31;最大:37),33周5天±1.66(min:25;max:37);1961.33±340克,1899.33±437.48克,结果无统计学差异(p=0.186,p=1,p=0.668)结论:常规经阴道环扎术对宫颈长度正常的双胎IVF妊娠预防早产无效。IVF双胞胎妇女通常在晚期出现,他们的出生体重也很低。
BACKGROUND: The incidence of twin pregnancies is on the rise worldwide due to assisted reproductive technologies. Cervical dilatation is a frequent complication and can be considered a cause of premature births in twin pregnancies. In vitro fertilization (IVF)
twins are more prone to preterm delivery. Routine cervical cerclage with normal cervical length is not recommended in
twins, but studies were not done on IVF
twins. So, this study aims to evaluate the effectiveness of routine transvaginal cerclage in twin IVF pregnancies with normal cervical length on maternofetal outcome.
METHODS: A retrospective case-control study was conducted at a maternity hospital in eastern India from January 2016 to December 2019 with over 21800 deliveries. Two groups were taken, cases were those IVF
twins with normal cervical length in whom cervical cerclage was done as they have referred to our hospital from the IVF centers for cerclage and in control no-cervical cerclage as they are referred from other IVF centers where cerclage was not a routine protocol. We have excluded cerclage done for history, ultrasound indicated, uterine anomalies, and monochorionic
twins. Fifteen participants were recruited in both cases and controls.
RESULTS: In our study 2 (6.66%), 4 (13%), and 26 (86%) were IVF twins delivered at a gestational age of <28 weeks, 28-32 weeks, and 32-37 weeks, respectively. The mean age of participants, mean gestation age at delivery, and birth weight in cases and control were 35.27 ± 5.98 years (min: 23; max: 45), 32.40 ± 5.54 years (min: 25; max: 44); 34 weeks 2 days ± 3.28 (min: 31; max: 37), 33 weeks 5 days ± 1.66 (min: 25; max: 37); 1961.33 ± 340 gram, 1899.33 ± 437.48 gram, respectively with no statistical significant difference (p = 0.186, p = 1, p = 0.668, respectively) Conclusion: Routine transvaginal cerclage is not effective in twin IVF pregnancies with normal cervical length for preventing preterm births. IVF twin women usually present at a late age and their birth weight are also low.