Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Arch Gynecol Obstet. 2010 Nov;282(5):553-60. doi: 10.1007/s00404-010-1531-0. Epub 2010 May 30.
To evaluate the outcome of hysteroscopic myomectomy in patients with infertility and recurrent abortions.
This was a retrospective clinical analysis of 186 patients who underwent hysteroscopic myomectomy by monopolar electrode loop. A second-look diagnostic hysteroscopy was performed in all cases within 2 months. The mean follow-up period was 36.5 months.
The mean age of the patients was 28.4 years. The presenting clinical complaint was primary infertility in 31% (62/200) patients, secondary infertility in 10% (20/200) patients, recurrent abortions in 50.5% (101/200) and preterm deliveries in 8.5% (17/200) patients. Final reproductive outcome was assessed for 186 patients, after excluding patients with other confounding factors, interfering in pregnancy outcome. There was a significant difference in reduction of number of miscarriages and increase in term deliveries while the number of preterm deliveries remained almost the same. Fifty-eight out of 82 infertile patients (70.7%) conceived after hysteroscopic myomectomy. The take home baby rate was increased from 16.2 to 74%. There was an increased incidence (35.6%) of cesarean section recorded in mode of delivery.
Hysteroscopic myomectomy is a safe and effective method for improving the obstetric outcome in women with infertility and recurrent abortions and associated submucous fibroids.
评估宫腔镜子宫肌瘤切除术治疗不孕和复发性流产患者的结局。
这是一项回顾性临床分析，共纳入 186 例行宫腔镜子宫肌瘤切除术的患者，均采用单极电环。所有患者均在术后 2 个月内行二次探查性宫腔镜检查。平均随访时间为 36.5 个月。
患者的平均年龄为 28.4 岁。主要临床表现为原发性不孕 31%（62/200），继发性不孕 10%（20/200），复发性流产 50.5%（101/200），早产 8.5%（17/200）。排除其他混杂因素干扰妊娠结局后，对 186 例患者进行了最终的生殖结局评估。与术前相比，流产次数减少，足月分娩增加，而早产率几乎保持不变。82 例不孕患者中有 58 例（70.7%）在宫腔镜子宫肌瘤切除术后妊娠。活产率从 16.2%提高到 74%。剖宫产率也有所增加（35.6%）。
宫腔镜子宫肌瘤切除术是一种安全有效的方法，可改善不孕和复发性流产合并黏膜下肌瘤患者的产科结局。
