Farrell J A, Albanese C T, Jennings R W, Kilpatrick S J, Bratton B J, Harrison M R
Department of Surgery, Division of Pediatric Surgery, Fetal Treatment Center, University of California, San Francisco, Calif., USA.
Fetal Diagn Ther. 1999 May-Jun;14(3):190-2. doi: 10.1159/000020918.
The purpose of this report is to assess the impact of fetal surgery on future maternal fertility, subsequent pregnancy outcome, and the incidence of pregnancy complications. Retrospective data were collected on 70 mothers who underwent fetal surgery between April 1981 and June 1996. Indications for open hysterotomy fetal surgery included congenital diaphragmatic hernia (n = 44), congenital cystic adenomatoid malformation of the lung (n = 11), urinary obstruction (n = 9), sacrococcygeal teratoma (n = 4), heart block (n = 1), and acardiac-acephalic twin reduction (n = 1). The following data were obtained: number of pregnancy attempts, number of successful pregnancies, pregnancy outcome including obstetrical and neonatal complications, and infertility after fetal surgery. There were 45 respondents, of whom 35 attempted subsequent pregnancies. Thirty-two were successful, resulting in 31 livebirths. Two women had a strong prefetal surgery history of infertility, 1 has only attempted to conceive for 3 months. We report this experience because the effect of open fetal surgery on futrue fertility is such an important question for our patients and referring physicians. This analysis suggests that hysterotomy and open fetal surgery has a negligible impact on maternal fertility.
本报告的目的是评估胎儿手术对未来母亲生育能力、后续妊娠结局以及妊娠并发症发生率的影响。收集了1981年4月至1996年6月期间接受胎儿手术的70名母亲的回顾性数据。开放性子宫切开术胎儿手术的指征包括先天性膈疝（n = 44）、先天性肺囊性腺瘤样畸形（n = 11）、尿路梗阻（n = 9）、骶尾部畸胎瘤（n = 4）、心脏传导阻滞（n = 1）以及无心无脑双胎减胎术（n = 1）。获得了以下数据：妊娠尝试次数、成功妊娠次数、包括产科和新生儿并发症在内的妊娠结局以及胎儿手术后的不孕情况。有45名受访者，其中35人尝试了后续妊娠。32人成功妊娠，产下31名活婴。两名女性在胎儿手术前有强烈的不孕病史，1人仅尝试受孕3个月。我们报告这一经验是因为开放性胎儿手术对未来生育能力的影响对我们的患者和转诊医生来说是一个非常重要的问题。该分析表明，子宫切开术和开放性胎儿手术对母亲的生育能力影响可忽略不计。
