Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA.
Fertil Steril. 2012 Jan;97(1):107-10. doi: 10.1016/j.fertnstert.2011.10.009. Epub 2011 Nov 17.
To determine the impact of sonographically identified large uterine fibroids (>5 cm in diameter) on obstetric outcomes.
Retrospective cohort study.
University teaching hospital.
PATIENT(S): Women with singleton gestations (n = 95) noted to have uterine fibroids on obstetric ultrasonography from September 2009 through April 2010 and age-matched controls (n = 95).
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Obstetric outcomes including short cervix, preterm premature rupture of membranes, and preterm delivery.
RESULT(S): Compared to women with no fibroids or small fibroids (≤5 cm), women with large fibroids (>5 cm) delivered at a significantly earlier gestational age (38.6 vs. 38.4 vs. 36.5 weeks). Short cervix, preterm premature rupture of membranes, and preterm delivery were also significantly more frequent in the large fibroid group, and were associated with number of fibroids >5 cm in diameter. Blood loss at delivery was significantly higher in the large fibroid group (486.8 vs. 535.6 vs. 645.1 mL), as was need for postpartum blood transfusion (1.1 vs. 0.0 vs. 12.2%).
CONCLUSION(S): Women with large uterine fibroids in pregnancy are at significantly increased risk for delivery at an earlier gestational age compared to women with small or no fibroids, as well as obstetric complications including excess blood loss and increased frequency of postpartum blood transfusion.
确定经超声检查识别的大型子宫肌瘤（直径>5 厘米）对产科结局的影响。
回顾性队列研究。
大学教学医院。
2009 年 9 月至 2010 年 4 月期间，在产科超声检查中发现有单发妊娠（n=95）且有子宫肌瘤的女性，并与年龄匹配的对照组（n=95）进行比较。
无。
产科结局，包括短宫颈、早产胎膜早破和早产。
与无肌瘤或小肌瘤（≤5 厘米）的女性相比，大肌瘤（>5 厘米）的女性分娩时间明显更早（38.6 周比 38.4 周比 36.5 周）。大肌瘤组的短宫颈、早产胎膜早破和早产的发生率也明显更高，且与直径>5 厘米的肌瘤数量有关。大肌瘤组的分娩出血量明显更高（486.8 毫升比 535.6 毫升比 645.1 毫升），产后输血的需求也更高（1.1%比 0.0%比 12.2%）。
与小肌瘤或无肌瘤的孕妇相比，妊娠合并大子宫肌瘤的女性分娩时间更早，且产科并发症风险增加，包括出血量增加和产后输血频率增加。
