A meta analysis on the efficacy of cervical cerclage in the treatment of placenta previa

ZHOU Min; NIE Yuxiang; CHEN Huijun

doi:10.14188/j.1671-8852.2024.0066

您当前的位置：

首页 >

文章列表页 >

A meta analysis on the efficacy of cervical cerclage in the treatment of placenta previa

更新时间：2026-11-05

- A meta analysis on the efficacy of cervical cerclage in the treatment of placenta previa
- Medical Journal of Wuhan University Vol. 46, Issue 6, Pages: 822-828(2025)
- 作者机构：
  
  武汉大学中南医院产科湖北武汉 430071
- 作者简介：
- 基金信息：
- DOI：10.14188/j.1671-8852.2024.0066
  CLC： R714
- Received：24 January 2024，
  
  Published：25 June 2025
- 稿件说明：
移动端阅览
周敏,聂宇翔,陈慧君.宫颈环扎术治疗前置胎盘疗效的Meta分析[J].武汉大学学报（医学版）,2025,46(06):822-828.

ZHOU Min,NIE Yuxiang,CHEN Huijun.A meta analysis on the efficacy of cervical cerclage in the treatment of placenta previa[J].Medical Journal of Wuhan University,2025,46(06):822-828.
周敏,聂宇翔,陈慧君.宫颈环扎术治疗前置胎盘疗效的Meta分析[J].武汉大学学报（医学版）,2025,46(06):822-828. DOI： 10.14188/j.1671-8852.2024.0066.

ZHOU Min,NIE Yuxiang,CHEN Huijun.A meta analysis on the efficacy of cervical cerclage in the treatment of placenta previa[J].Medical Journal of Wuhan University,2025,46(06):822-828. DOI： 10.14188/j.1671-8852.2024.0066.

摘要

目的

采用Meta分析的方法评价宫颈环扎术治疗前置胎盘的临床治疗效果。

方法

综合检索PubMed、Embase、Cochrane Library、万方（Wanfang）、知网（CNKI）、维普（VIP）、中国生物医学（CBM）数据库，纳入国内外报道宫颈环扎治疗前置胎盘的文献，检索年限从1990年1月至2023年12月，采用RevMan 5.3软件进行Meta分析，以相对危险度（

）和加权均数差（

）的95%可信区间（

）表示结局指标的效应量

分别采用

检验和

值进行异质性检验。

结果

本研究共纳入了13篇研究（共739例），其中环扎组387例，对照组352例。Meta分析结果显示，相比于期待治疗，宫颈环扎组延长分娩的孕周（

=2.60，95%

：1.86~3.35，

0.000 01），延长妊娠的孕周（

=2.83，95%

：2.93~3.28，

0.000 01)，增加新生儿出生平均体质量（

=639.47，95%

：340.92~938.02，

0.000 1），减少产前出血量（

=-172.54，95%

：-341.21~-3.86，

=0.04），减少产时输血的次数（

=0.29，95%

：0.12~0.70，

=0.006），减少围产儿死亡数（

=0.13，95%

：0.06~0.30，

0.000 01），差异均具有统计学意义。

结论

宫颈环扎术治疗前置胎盘优于期待治疗策略，宫颈环扎术治疗前置胎盘相对安全有效。

Abstract

Objective

To conduct a meta⁃analysis to evaluate the clinical treatment effects of cervical cerclage in managing placenta previa.

Methods

This study conducted a comprehensive search of PubMed

Embase

Cochrane Library

Wanfang

CNKI

VIP

and CBM databases. Literature on cervical cerclage for treating placenta previa was i

ncluded

with the search period from January 1990 to December 2023. Meta⁃analysis was performed using RevMan 5.3 software

and the effect sizes of outcome indicators were expressed as relative risks (

) and weighted mean differences (

) with 95% confidence intervals (

⁃test and

values were used for heterogeneity testing.

Results

The study included a total of 13 studies (739 cases)

with 387 cases in the cervical cerclage group and 352 cases in the control group. The meta⁃analysis results showed that

as compared with the expectant management group

the cervical cerclage group had a prolonged gestational age at delivery (

=2.60

95%

: 1.86⁃3.35，

0.000 01)

extended duration of pregnancy (

=2.83

95%

: 2.93‑3.28

0.000 01)

increased average birth weight of newborns (

=639.47

95%

: 340.92⁃938.02

0.000 1)

reduced antepartum bleeding (

=-172.54

95%

: -341.21⁃-3.86

=0.04)

decreased number of blood transfusions during labor （

=0.29

95%

: 0.12⁃0.70

=0.006)

and reduced perinatal mortality (

=0.13

95%

: 0.06⁃0.30

0.000 01）. These differences were statistically significant.

Conclusion

This meta⁃analysis found that cervical cerclage treatment for placenta previa bleeding is superior to expectant management

and cervical cerclage treatment is relatively safe and effective.

关键词

Keywords

references

JENABI E , BASHIRIAN S , KHOSHRAVESH S . The association between of placenta previa and congenital abnormalities: A systematic review and network meta⁃analysis [J ] . BMC Pediatr , 2023 , 23 ( 1 ): 606 .

CHEN Z , LI J , SHEN J , et al . Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta [J ] . Int J Gynecol Obstet , 2021 , 135 ( 5 ): 264 ⁃ 268 .

WANG Y , HU C , PAN N , et al . Prophylactic uterine artery embolization in second⁃trimester pregnancy termination with complete placenta previa [J ] . J Int Med Res , 2019 , 47 ( 1 ): 345 ⁃ 352 .

巩春杰 , 王妍 . 妊娠中期胎盘前置状态的转归和围产结局研究进展 [J ] . 中国妇产科临床杂志 , 2023 , 24 ( 3 ): 331 ⁃ 333 .

GONG C J , WANG Y . Research progress on the prognosis and perinatal outcomes of placenta previa in mid pregnancy [J ] . Chinese Journal of Clinical Obstetrics and Gynecology , 2023 , 24 ( 3 ): 331 ⁃ 333 .

PINTON A , DENEUX⁃THARAUX C , SECO A , et al . Incidence and risk factors for severe postpartum haemorrhage in women with anterior low⁃lying or praevia placenta and prior caesarean: Prospective population⁃based study [J ] . BJOG , 2023 , 130 ( 13 ): 1653 ⁃ 1661 .

CRESSWELL J A , RONSMANS C , CALVERT C , et al . Prevalence of placenta praevia by world region: A systematic review and meta⁃analysis [J ] . Trop Med Int Health , 2013 , 18 ( 6 ): 712 ⁃ 724 .

李青 , 王志坚 , 余艳红 , 等 . 中国部分地区前置胎盘流行病学调查 [J ] . 中国实用妇科与产科杂志 , 2014 , 30 ( 10 ): 786 ⁃ 790 .

LI Q , WANG Z J , YU Y H , et al . Epidemiological survey on placenta previa in seven regions of China [J ] . Chinese Journal of Practical Gynecology and Obstetrics , 2014 , 30 ( 10 ): 786 ⁃ 790 .

JA U E , GRONBECK L , BUNCE C , et al . Epidemiology of placenta previa accreta:A systematic review and meta⁃analysis [J ] . BMJ Open , 2019 , 9 ( 11 ): e031193 .

LASH A F , LASH S R . Habitual abortion; the incompetent internal os of the cervix [J ] . Am J Obstet Gynecol , 1950 , 59 ( 1 ): 68 ⁃ 76 .

STERNE J A C , SAVOVIĆ J , PAGE M J , et al . RoB 2: A revised tool for assessing risk of bias in randomised trials [J ] . BMJ , 2019 , 366 : l4898 .

JASWAL A , MANAKTALA U , SHARMA J B . Cervical cerclage in expectant management of placenta previa [J ] . Int J Gynecol Obstet , 2006 , 93 ( 1 ): 51 ⁃ 52 .

COBO E , CONDE AGUDELO A , DELGADO J , et al . Cervical cerclage: An alternative for the management of placenta previa? [J ] . Am J Obstet Gynecol , 1998 , 179 ( 1 ): 122 ⁃ 125 .

刘太芝 , 范宝会 . 宫颈环扎术治疗完全性前置胎盘的临床疗效 [J ] . 中国保健营养 , 2021 , 31 ( 23 ): 98 .

LIU T Z , FAN B H . Clinical efficacy of cervical cerclage in the treatment of complete placenta previa [J ] . China Health Care & Nutrition , 2021 , 31 ( 23 ): 98 .

梁天箭 , 李海静 . 宫颈环扎术治疗中央性前置胎盘的疗效观察 [J ] . 现代诊断与治疗 , 2016 , 27 ( 4 ): 687 ⁃ 688 .

LIANG T J , LI H J . Observation on the efficacy of cervical cerclage in the treatment of central placenta previa [J ] . Modern Diagnosis & Treatment , 2016 , 27 ( 4 ): 687 ⁃ 688 .

王瑶 , 邱锦 , 金鑫 . 探讨应用宫颈环扎术治疗前置胎盘伴出血的疗效 [J ] . 齐齐哈尔医学院学报 , 2015 , 36 ( 3 ): 370 ⁃ 371 .

WANG Y , QIU J , JIN X . Exploring the efficacy of using cervical cerclage in the treatment of placenta previa with bleeding [J ] . Journal of Qiqihar University of Medicine , 2015 , 36 ( 3 ): 370 ⁃ 371 .

陈琪瑛 . 宫颈环扎术在前置胎盘出血治疗中的应用 [J ] . 中外医学研究 , 2012 , 10 ( 18 ): 12 ⁃ 13 .

CHEN Q Y . Application of cervical cerclage in intervention placenta previa bleeding [J ] . Chinese and Foreign Medical Research , 2012 , 10 ( 18 ): 12 ⁃ 13 .

谭奇英 , 彭婀娜 . 宫颈环扎术治疗前置胎盘60例 [J ] . 临床医药实践 , 2010 , 19 ( 4B ): 469 ⁃ 471 .

TAN Q Y , PENG E N . Cervical cerclage for the treatment of placenta previa in 60 cases [J ] . Proceeding of Clinical Medicine , 2010 , 19 ( 4B ): 469 ⁃ 471 .

伍晓容 . 宫颈环扎术治疗中央性前置胎盘疗效分析 [J ] . 中国实用医药 , 2010 , 5 ( 15 ): 166 ⁃ 167 .

WU X R . Analysis of the efficacy of cervical cerclage in the treatment of central placenta previa [J ] . China Practical Medicine , 2010 , 5 ( 15 ): 166 ⁃ 167 .

李洪华 , 陈鹤 . 宫颈环扎术治疗中央性前置胎盘15例分析 [J ] . 中国社区医师 , 2010 , 12 ( 31 ): 104 .

LI H H , CHEN H . Analysis of 15 cases of central placenta previa treated with cervical cerclage [J ] . Chinese Community Doctors , 2010 , 12 ( 31 ): 104 .

赵梦琳 , 高大汉 . 中央性前置胎盘60例临床分析 [J ] . 中国煤炭工业医学杂志 , 2009 , 12 ( 1 ): 86 ⁃ 87 .

ZHAO M L , GAO D H . Clinical analysis of 60 cases of central placenta previa [J ] . Chinese Journal of Coal Industry Medicine , 2009 , 12 ( 1 ): 86 ⁃ 87 .

林红 , 夏平 . 宫颈环扎术治疗中央性前置胎盘的疗效观察 [J ] . 华中医学杂志 , 2003 , 27 ( 6 ): 325 ⁃ 326 .

LIN H , XIA P . Observation on the efficacy of cervical cerclage in the treatment of central placenta previa [J ] . Central China Medical Journal , 2003 , 27 ( 6 ): 325 ⁃ 326 .

黄海宝 , 郭松成 , 奴尔曼 . 宫颈环扎术治疗中央性前置胎盘40例临床分析 [J ] . 新疆医科大学学报 , 2002 , 25 ( 1 ): 71 .

HUANG H B , GUO S C , NU E M . Clinical analysis of 40 cases of central placenta previa treated with cervical cerclage [J ] . Journal of Xinjiang Medical University , 2002 , 25 ( 1 ): 71 .

李长忠 , 吴美琳 , 孙金芳 . 应用宫颈环扎术治疗中央型前置胎盘40例临床分析 [J ] . 山东医药 , 2000 , 40 ( 20 ): 33 ⁃ 34 .

LI C Z , WU M L , SUN J F . Clinical analysis of the application of cervical cerclage in the treatment of central placenta previa in 40 cases [J ] . Shandong Medical Journal , 2000 , 40 ( 20 ): 33 ⁃ 34 .

ZAITOUN M M , EL BEHERY M M , ABD EL HAMEED A A , et al . Does cervical length and the lower placental edge thickness measurement correlates with clinical outcome in cases of complete placenta previa? [J ] . Arch Gynecol Obstet , 2011 , 284 ( 4 ): 867 ⁃ 873 .

GHI T , CONTRO E , MARTINA T , et al . Cervical length and risk of antepartum bleeding in women with complete placenta previa [J ] . Ultrasound Obstet Gynecol , 2009 , 33 ( 2 ): 209 ⁃ 212 .

SEKIGUCHI A , NAKAI A , OKUDA N , et al . Consecutive cervical length measurements as a predictor of preterm cesarean section in complete placenta previa [J ] . J Clin Ultrasound , 2015 , 43 ( 1 ): 17 ⁃ 22 .

STAFFORD I A , DASHE J S , SHIVVERS S A , et al . Ultrasonographic cervical length and risk of hemorrhage in pregnancies with placenta previa [J ] . Obstet Gynecol , 2010 , 116 ( 3 ): 595 ⁃ 600 .

ALTRAIGEY A , ELLAITHY M , BARAKAT E , et al . Cervical length should be measured for women with placenta previa: Cohort study [J ] . J Matern Fetal Neonatal Med , 2021 , 34 ( 13 ): 2124 ⁃ 2131 .

ALFIREVIC Z , STAMPALIJA T , MEDLEY N . Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy [J ] . Cochrane Database Syst Rev , 2017 , 6 ( 6 ): CD008991 .

BROWN R , GAGNON R , DELISLE M F . No. 373⁃cervical insufficiency and cervical cerclage [J ] . J Obstet Gynaecol Can , 2019 , 41 ( 2 ): 233 ⁃ 247 .

NEILSON J P . Interventions for suspected placenta praevia [J ] . Cochrane Database Syst Rev , 2003 , (2):CD001998.

JAIN V , BOS H , BUJOLD E . Guideline No.402: Diagnosis and management of placenta previa [J ] . J Obstet Gynaecol Can , 2020 , 42 ( 7 ): 906 ⁃ 917 .

PARK H S , CHO H S . Management of massive hemorrhage in pregnant women with placenta previa [J ] . Anesth Pain Med (Seoul) , 2020 , 15 ( 4 ): 409 ⁃ 416 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Influence of evidence⁃based cognitive⁃motor dual⁃task training on limb motor function in young patients with hemiplegia after first ischemic stroke

Safety and effectiveness of high⁃frequency oscillatory ventilation for the treatment of acute respiratory distress syndrome: A meta⁃analysis

Efficacy and safety of sucrose⁃hydroxy iron oxide in the treatment of hyperphosphatemia and uremic anemia in dialysis patients: A meta⁃analysis

Effect of opioid analgesia on postoperative intestinal recovery： A meta⁃analysis

Effect of propofol on airway inflammation in asthmatic mice via regulation of the Nrf2/HO‑1 signaling pathway

Related Author

ZHOU Min

CHEN Huijun

CHEN Meigui

MEI Bin

XIE Fei

SHANG Qiaomei

CHEN Xiong

CHEN Jianguo

Related Institution

Department of Neurology, Affiliated Hospital of Hubei University of Traditional Chinese Medicine

Department of Electronics and Information Science, Xi'an Jiaotong University

Brain Disease Zone 3, Hubei Zhongxiang Traditional Chinese Medicine Hospital, Zhongxiang

Department of Neurology, Zhongnan Hospital of Wuhan University

Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital

AI问答

⁰