Efficacy Of Laparoscopic Cervical Oerclage In Chinese Patients With Cervical Incompetence:A Meta-analysis

Objective:The meta-analysis was designed to compare the efficacy of laparoscopic transabdominal cervical cerdage and transvagnal cervical cerclage of Chinese women with cervical incompetence.Method:A computerized search was perfomed in The database of CNKI、CBM、VIP、RubMed,Web of science and Wanfang Database And search other journals manually,to identify controled trials comparing the efficacy of laparoscpic transabdominal cervical cerclage versus transvagnal cervical cerdage in the treatment of cervical insufficiency among the Chinese.All studies consistent with pre-established inclusion criteria were included and the related dat a were extracted,the Peview Manager 5.3 were used for data analysis The evaluation indexes of the retrieved literature in this study indudedterm delivery rate;prerrature delivery rate;abortion rate;mean value neonatal weight;operation time;blood loss volune,hospital stay.Results:A total of 11 FCTs and 20 cohort studes were induded in a total of 2174 patierts(1078 patients underwent laparcscopic transabdominal cervical cerdage(LTcC),1096 patients underwent transvaginal cervical ceralage(TVOC)).The results of meta-analysis showed that compared with TVOC goup,the LTCC group had higher rate of term birth[OR=5.22,95%CI(4.13,6.61),P<0.00001]lower rate of abortion rate[R=0.16,950%CI(0.11,0.22),P<0.00001],lower rate of prenature delivery[R=.30,95%Cl(0.23,0.39),P<0.00001],the higher meanvaluenecatal weight[MD=410.71,95%CI(333.36,488.06),P<0.00001],lowerblood loss vdume[MD=9.51,95%CI(-13.02,-6),P<0.00001]and shorterhospial stay[MD=3.07,95%CI(-4.06,-2.07),P<0.00001],the operation timenthe two goups was not significantly different.[MD=4.50,95%CI(-6.41,-2.59),P<0.00001].Condusion:The current research evidence shows that LTCC resulted in less blood loss vdume and shorter hospital stay than TVCC there vas no statistically significant difference in operation time In terms of improcing pregnaancy outcome the results of LTCC are more satisfactory,with lower abortion rate and premature birth rate,higher term delivery rate and newborn weight,which is worthy of cinical application.LTOC is a more suitable choice for elderly pregrant wonmen with repeated abortions and pregnant patients with assisted reproduction of precious infants.