背景:宮頸機(jī)能不全是由宮頸功能或結(jié)構(gòu)缺陷導(dǎo)致宮頸不能支撐到足月妊娠。典型的表現(xiàn)是在孕中晚期無痛的,進(jìn)行性宮頸擴(kuò)張,導(dǎo)致胎膜膨出,胎膜早破(PROM),中期流產(chǎn)或早產(chǎn)。其發(fā)病率在妊娠人數(shù)的0.1%至2%之間,在16至28周內(nèi)約占習(xí)慣性流產(chǎn)的15%。這是早產(chǎn)(PTB)的一個重要因素。每年估計有1300萬人早產(chǎn),超過100萬的嬰兒死于并發(fā)癥。雖然在過去的幾年里中國的新生兒護(hù)理已大大改善,在妊娠28周前出生的嬰兒存活率<50%,在幸存的嬰兒中發(fā)生中度至重度殘疾的不占少數(shù)。這給母親和她的家庭在精神及經(jīng)濟(jì)上形成負(fù)擔(dān)。因此,避免由宮頸機(jī)能不全引起的早產(chǎn)和中期妊娠流產(chǎn)成為產(chǎn)科醫(yī)生的一大挑戰(zhàn)。盡管有爭議,經(jīng)陰道宮頸環(huán)扎術(shù)在幾十年內(nèi)仍然是治療宮頸機(jī)能不全的主要手段。一些研究表明,經(jīng)歷宮頸環(huán)扎術(shù)的妊娠期婦女與有同樣宮頸機(jī)能不全并且進(jìn)行臥床休息或安胎治療婦女相比,前者在延長孕周和新生兒的生存率上具有更有利的結(jié)局。在這項研究中,我們通過比較選擇性和緊急環(huán)扎術(shù)在延長孕周、并發(fā)癥及新生兒結(jié)局等方面上來評估單胎妊娠中以McDonald術(shù)式行經(jīng)陰道環(huán)扎術(shù)的有效性并確定影響其預(yù)后的預(yù)測因素。這些信息可以幫助病人和她的...

【文章頁數(shù)】：81 頁

【學(xué)位級別】：碩士

【文章目錄】：
中文摘要
abstract
Chapter 1 Literature Review
    1.1 Introduction
    1.2 Incidence and Classification
    1.3 Structure of the Cervix
        1.3.1 Anatomical Structure of the Cervix
        1.3.2 Histological Structure of the Cervix
    1.4 Function of the Cervix
        1.4.1 Composition and Physiological function of Cervical Mucus
        1.4.2 Cervical Changes in Pregnancy and Labour
    1.5 Etiology and Risk factors for Cervical Incompetence
        1.5.1 Cervical incompetence and Congenital cervical dysplasia
        1.5.2 Cervical incompetence and Prenatal exposure to Diethylstilbestrol
        1.5.3 Cervical incompetence and Polycystic ovarian syndrome (PCOS)
        1.5.4 Genetic factors of Cervical Incompetence
        1.5.5 Cervical incompetence and Surgical trauma
        1.5.6 Cervical incompetence and Cervical surgery
        1.5.7 Cervical incompetence and Serum relaxin levels
    1.6 Diagnosis of Cervical Incompetence
        1.6.1 Patient History
        1.6.2 Symptoms
        1.6.3 Physical Examination
        1.6.4 Sonographic Diagnosis
        1.6.5 Diagnostic Tests
    1.7 Management of Cervical Incompetence
        1.7.1 Conservative Observational Management
        1.7.2 Surgical Treatment
    1.8 Cervical Cerclage
        1.8.1 Types of Cervical cerclage
        1.8.2 Indications of Cervical cerclage
        1.8.3 Contraindications to Cerclage insertion
        1.8.4 Complications of Cervical cerclage
        1.8.5 Preoperative Management
        1.8.6 Operative Issues
        1.8.7 Postoperative Care
        1.8.8 Removal of Cerclage
        1.8.9 Prevention of Cervical Incompetence
Chapter 2 Aims and Objectives
    2.1 Hypothesis
    2.2 Aims and Objectives
Chapter 3 Material and Methods
    3.1 Study Design
    3.2 Study Population
        3.2.1 Inclusion Criteria
        3.2.2 Exclusion Criteria
    3.3 Methodology
    3.4 Statistical Analysis
Chapter 4 Results
    4.1 Study Population
    4.2 Neonatal Outcomes
    4.3 Elective and Emergency cerclage
Chapter 5 Discussion
    5.1 Efficacy and Safety of Transvaginal cervical cerclage
    5.2 Predictive Factors of Success and Failure
    5.3 Elective and Emergency cerclage
Chapter 6 Conclusion
References
Supervisor Introduction
Self Introduction
Acknowledgements



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