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目的探讨晚期妊娠合并子宫肌瘤对妊娠结局的影响。方法回顾性分析302例妊娠合并子宫肌瘤患者(肌瘤组)的临床资料,以同期妊娠无子宫肌瘤孕妇283例作为对照组,对其妊娠期并发症、分娩期并发症、分娩方式、手术中处理及新生儿结局进行比较。结果妊娠合并大于5 cm肌壁间子宫肌瘤患者发生早产、胎位异常、前置胎盘、胎儿窘迫、产后出血及低体重儿的风险大于对照组(P<0.01)。剖宫产术中行浆膜下及小型肌壁间肌瘤剔除并不增加术中出血风险(P<0.01)。术中剔除的肌瘤组织常规送病检,变性120例,变性率为71.4%。结论大于5 cm的肌壁间肌瘤增加产科并发症的风险。孕期肌瘤变性率高。浆膜下及小型肌壁间肌瘤剖宫产术中行肌瘤剔除术是安全可行的。
Objective To investigate the effect of pregnancy complicated with uterine myoma in late pregnancy. Methods The clinical data of 302 pregnant women with myoma of uterus (myoma group) were retrospectively analyzed. 283 pregnant women without uterine fibroids in the same period were enrolled as control group. Their complications during pregnancy, complications during delivery, mode of delivery, Surgical treatment and neonatal outcomes were compared. Results The risk of preterm birth, abnormal fetal position, placenta previa, fetal distress, postpartum hemorrhage and low birth weight were higher in pregnant women with uterine fibroids than 5 cm (P <0.01). In cesarean section, subserosal submucosal and intramyocular myomectomy did not increase the risk of intraoperative bleeding (P <0.01). Intraoperative rejection of fibroids routine sent disease examination, degeneration in 120 cases, the degeneration rate was 71.4%. Conclusion Muscular myomectomy greater than 5 cm increases the risk of obstetric complications. High incidence of myoma during pregnancy. Subserosal and small intramural fibroids myomectomy myogenic excision is safe and feasible.