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目的探讨妊娠合并子宫肌瘤的诊断、临床表现以及孕期处理方式对妊娠结局及胎儿的影响。方法对松原市中心医院妇产科2006年1月—2012年12月收治的经超声诊断、手术证实及病理诊断的160例妊娠合并子宫肌瘤病例进行回顾性分析。结果妊娠合并子宫肌瘤患者160例中孕早期发现89例,孕前发现23例,孕中期发现28例,剖宫产术中发现20例。剖宫产术后做病理发现肌瘤变性24例,其中玻璃样变7例,囊性变13例,红色变性4例,其中直径>5.0cm的肌瘤更易发生变性(P<0.05)。妊娠合并子宫肌瘤剖宫产患者75例,其中浆膜下肌瘤58例,肌壁间肌瘤17例;流产10例,行人工流产25例,经阴道分娩50例。无切子宫病例,无产后出血病例。结论孕末期子宫体部肌瘤直径<5.0cm妊娠期间是相对安全的,不会发生产后出血,对胎儿无不良影响。
Objective To investigate the diagnosis, clinical manifestations and treatment of pregnant women with uterine fibroids during pregnancy outcome and fetus. Methods A retrospective analysis was performed on 160 pregnant women with uterine leiomyoma diagnosed by ultrasonic diagnosis, operation confirmation and pathological diagnosis from January 2006 to December 2012 in Songyuan Central Hospital Obstetrics and Gynecology. Results In the first trimester of pregnancy, 160 cases of uterine fibroids were found in 89 cases, 23 cases before pregnancy, 28 cases in the second trimester and 20 cases in cesarean section. Twenty-four cases of fibroid degeneration were found after cesarean section, including 7 cases of hyalinization, 13 cases of cystic degeneration and 4 cases of red degeneration. The fibroids with diameters> 5.0 cm were more easily degenerated (P <0.05). There were 75 cases of cesarean section in pregnancy with uterine fibroids, including 58 cases of subserosal fibroids and 17 cases of intramural fibroids; 10 cases of abortion, artificial abortion in 25 cases and vaginal delivery in 50 cases. No case of uterine incision, no case of postpartum hemorrhage. Conclusion The end of pregnancy end uterine fibroids diameter <5.0cm during pregnancy is relatively safe, will not occur postpartum hemorrhage, no adverse effects on the fetus.