Japanese

Title	子宮頸管無力症に対する子宮頸管縫縮術の治療効果についての検討
Subtitle	原著
Authors	岡見ゆりか, 津田弘之, 手塚敦子, 伊藤由美子, 齋藤愛, 坂堂美央子, 廣村勝彦, 安藤智子
Authors (kana)
Organization	日本赤十字社愛知医療センター名古屋第一病院 産婦人科
Journal	日本周産期・新生児医学会雑誌
Volume	61
Number	1
Page	39-43
Year/Month	2025 / 5
Article	原著
Publisher	日本周産期・新生児医学会
Abstract	「概要」目的:子宮頸管縫縮術において縫縮糸の深さが妊娠期間に及ぼす影響を検討した. 方法:2018年7月から2023年6月に子宮頸管縫縮術を施行した102例を対象とし後方視的に検討した. 結果:予防的頸管縫縮術(予防群)が50例, 治療的頸管縫縮術(治療群)が52例であった. 治療群において治療前後の頸管長, 縫縮糸の深さはそれぞれ妊娠延長期間と有意な正の相関を示した(P<0.001). 重回帰分析では妊娠延長期間に対しBMI, 縫縮術の施行週数, 治療後頸管長が有意(P<0.001)であったが, 縫縮糸の深さは有意ではなかった. ROC曲線における治療後頸管長のcutoff値は20mmであった. 結論:治療的子宮頸管縫縮術において, 縫縮糸の深さではなく治療後頸管長が妊娠期間延長と有意に関連していた. 子宮頸管縫縮術においては治療後頸管長>20mmを目指した治療が望ましい.
Practice	臨床医学：外科系
Keywords	Cervical cerclage, Cervical insufficiency, Short cervix, Preterm birth

English

Title	A study of the therapeutic efficacy of cervical cerclage in the cervical insufficiency
Subtitle
Authors	Yurika Okami, Hiroyuki Tsuda, Atsuko Tezuka, Yumiko Ito, Ai Saito, Mioko Hando, Katsuhiko Hiromura, Tomoko Ando
Authors (kana)
Organization	Obstetrics and Gynecology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
Journal	Journal of Japan Society of Perinatal and Neonatal Medicine
Volume	61
Number	1
Page	39-43
Year/Month	2025 / 5
Article	Original article
Publisher	Japan Society of Perinatal and Neonatal Medicine
Abstract	Objective:Cervical insufficiency is one of the major causes of preterm birth (PTB), and cervical cerclage is commonly used for its treatment. Although there are reports suggesting that cerclage depth (from cerclage to external os) affects the duration of prolonged pregnancy, a consensus has not yet been achieved. Therefore, we retrospectively reviewed cases of cervical cerclage performed in our hospital over the past 5 years. Methods:We reviewed the medical records of 102 cases who underwent cervical cerclage at our hospital from July 2018 to June 2023, and investigated the perinatal outcomes. Results:Prophylactic cervical cerclage (prophylactic group) was performed in 50 patients and therapeutic cervical cerclage (therapeutic group) was performed in 52 patients. PTB was defined as less than 36 weeks. 7 cases (14%) in the prophylactic group and 15 cases (28%) in the therapeutic group had PTB. The duration of prolonged pregnancy was 134 (+-27.0) days in the prophylactic group and 95 (+-28.0) days in the therapeutic group (P<0.001). In the therapeutic group, cervical length before and after cerclage and cervical depth showed a significant positive correlation with the duration of prolonged pregnancy, respectively. Multiple regression analysis showed that BMI (β=-1.85, P=0.005), gestational age(β=-0.62, P<0.001), and post-treatment cervical length (β=1.81, P<0.001) were significant, but the cerclage depth (P=0.715) was not significant. Conclusion:In therapeutic cervical cerclage, post-treatment cervical length, not cerclage depth, was significantly associated with the extension of the pregnancy period. Post-treatment cervical length of > 20 mm should be achieved when performing cervical cerclage to improve pregnancy outcome.
Practice	Clinical surgery
Keywords	Cervical cerclage, Cervical insufficiency, Short cervix, Preterm birth

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