Tian Jishun, Hu Wensheng
Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Aust N Z J Obstet Gynaecol. 2012 Jun;52(3):258-61. doi: 10.1111/j.1479-828X.2012.01414.x. Epub 2012 Feb 23.
To analyse the management strategies and delivery outcomes of women with cervical leiomyomas in pregnancy.
We retrospectively analysed the pregnancy outcomes of 17 women with cervical leiomyomas. The outcome measures assessed included the volume of blood loss at delivery, need for blood transfusion, intra- and post-operative complications and length of hospital stay.
The mean diameter of the leiomyomas was 10.4 ± 7.2 cm, with a range of 3-30 cm. The mean blood loss was 697 ± 394 mL (range of 350-4200 mL). Six women (35.3%) required a blood transfusion. The mean duration of stay in hospital after delivery was 7.9 ± 3.9 days (range 4-20 days). There were three cases of severe haemorrhage or infection post-operation necessitating hysterectomy, and all of the leiomyomas in these cases were more than 20 cm in diameter. There was a positive correlation between the blood loss volume and the size of leiomyomas (correlation coefficient 0.638, P < 0.01).
The dimensions of cervical leiomyomas influences post-partum blood loss. Large cervical leiomyomas appear associated with adverse outcomes. When the leiomyomas are relatively small, an experienced practitioner could consider myomectomy during a caesarean delivery.
分析妊娠合并宫颈平滑肌瘤患者的管理策略及分娩结局。
我们回顾性分析了17例妊娠合并宫颈平滑肌瘤患者的妊娠结局。评估的结局指标包括分娩时的失血量、输血需求、手术中和术后并发症以及住院时间。
平滑肌瘤的平均直径为10.4±7.2cm，范围为3 - 30cm。平均失血量为697±394mL（范围为350 - 4200mL）。6例患者（35.3%）需要输血。分娩后平均住院时间为7.9±3.9天（范围为4 - 20天）。有3例术后发生严重出血或感染，需行子宫切除术，这些病例中的所有平滑肌瘤直径均超过20cm。失血量与平滑肌瘤大小呈正相关（相关系数0.638，P<0.01）。
宫颈平滑肌瘤的大小影响产后失血量。较大的宫颈平滑肌瘤似乎与不良结局相关。当平滑肌瘤相对较小时，经验丰富的医生可考虑在剖宫产时行肌瘤切除术。
