Abstract:

Cervical insufficiency（CI），described as the inability of the uterine cervix to retain a pregnancy in the absence of the signs and symptoms of clinical contractions，which is one of the main reasons leading to second-trimester pregnancy loss and preterm birth.Pathogenesis of CI is uncertain.The acquired CI such as prior loop electrosurgical excision procedure，cone biopsy and prior vaginal radical trachelectomy brings new challenges.At present there is no guideline or consensus for the screening and management of CI.Compared with expectant treatment，role of cervical cerclage remains controversial.The article attempts to review the relevant studies on the cervical cerclage for the treatment of cervical insufficiency.

Key words: preterm birth, cervical insufficiency, cervical cerclage

摘要：

宫颈机能不全指宫颈无法保留其正常的形态及功能直至妊娠足月，表现为无痛性宫口扩张、胎儿娩出导致妊娠丢失，是引起妊娠中晚期流产及早产的常见原因。宫颈机能不全的发病机制并不明确，近年来出现的获得性宫颈机能不全如宫颈锥切术后、保留子宫体的宫颈癌根治术后患者有所增多，临床实践中关于宫颈机能不全的筛查、诊断和处理没有统一的规范，宫颈环扎术与保守治疗相比是否获益更多一直存在争议。文章就宫颈环扎术的适应证、术式的改良与进展做一阐述。

关键词: 早产, 宫颈机能不全, 宫颈环扎术