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在宫 cerclage 最佳的手术技术,以防止流产,一个系统的审查

Matthew Vaughan¹, Alexandra Emms², Victoria Hodgetts Morton²

¹University of Birmingham Medical School, Edgbaston, Birmingham B15 2TT, UK.

European journal of obstetrics, gynecology, and reproductive biology

|October 10, 2025

概括

像Shirodkar (用剖析) 和麦当劳 (没有) 这样的宫 cerclage 技术显示出类似的妊娠损失率. 然而,希罗德卡尔的方法可能会延长怀孕,减少非常早产.

科学领域:

产科和妇科产科和妇科
孕产妇和胎儿医学孕产妇和胎儿医学
手术创新在外科创新.

背景情况:

宫围是预防早产的一个关键干预措施.
对于宫围的最佳手术技术仍在争论中.
希罗德卡和麦当劳手术代表着有或没有膀剖析的不同方法.

研究的目的:

为了比较Shirodkar的技术 (有膀剖析) 与麦当劳的技术 (没有剖析) 在宫 cerclage 的疗效.
为了评估这两种技术之间的怀孕流产和母胎结局的差异.
评估双重围在预防早产的潜在好处.

主要方法:

进行了对相关文献的系统审查.
通过对MEDLINE,Embase,CINAHL和Cochrane图书馆的全面搜索来确定研究.
使用ROBINS-I和ROB2工具评估了Bias,随后使用RevMan软件进行了元分析.

主要成果:

在Shirodkar和麦当劳技术之间没有观察到怀孕丧失或在37周前分娩的显著差异.
希罗德卡的技术与怀孕延长2周和减少32周之前的分娩有关.
双 cerclage 显示减少了怀孕失误和出生在28周,32周和34周之前,但不是在37周之前.

结论:

希罗德卡或麦当劳的技术都没有显示出怀孕流产率的差异.
在希罗德卡的技术中进行膀剖析可能会导致妊娠延长,并减少非常早产.
双重 cerclage 可能为预防早产提供额外的好处,尽管证据质量较低. 技术选择应该是个性化的.

关键词:

膀剖析膀剖析是指进行膀剖析.这是一个双重的 cerclage.麦当劳的圈套麦当劳圈套过早分娩过早分娩是什么希罗德卡尔的圈套通过阴道的 cerclage.

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