Leath Charles A, Bevis Kerri S, Numnum T Michael, Ramsey Patrick S, Huh Warner K, Straughn J Michael
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama School of Medicine, 1700 6th Avenue South, Room 10250, Birmingham, AL 35249, USA.
J Reprod Med. 2013 Jul-Aug;58(7-8):279-84.
To compare the operative data and complications of radical hysterectomy performed on pregnant women versus nonpregnant women.
Following institutional review board approval, we reviewed our surgical databases to identify pregnant women who had undergone a radical hysterectomy for cervical carcinoma from 1992-2005 (n = 7). A nonpregnant control group (n = 35) of women undergoing radical hysterectomy during the study interval were identified and matched for age, year of surgery, and surgeon. Pertinent operative and outcome data were abstracted and compared.
Of the 7 women who had undergone a radical hysterectomy during pregnancy, 4 had a cesarean radical hysterectomy at a mean gestational age of 35.4 weeks (range, 32.3-38 weeks) and 3 had a radical hysterectomy with a previable fetus in situ at a mean gestational age of 14.2 weeks. Demographics were similar between groups. Transfusion rates were significantly higher among pregnant women (57%) as compared to nonpregnant controls (9%) (p = 0.0009). The overall incidence of operative complications was similar between the pregnant women (43%) and nonpregnant controls (40%) (p = NS).
Radical hysterectomy performed in pregnant women was associated with higher blood loss and increased need for transfusion as compared to nonpregnant controls. No differences were observed in regards to other operative surgical complications between the two groups.
比较孕妇与非孕妇行根治性子宫切除术的手术数据及并发症情况。
经机构审查委员会批准后，我们查阅了手术数据库，以确定1992年至2005年间因宫颈癌接受根治性子宫切除术的孕妇（n = 7）。确定了研究期间接受根治性子宫切除术的非孕妇对照组（n = 35），并在年龄、手术年份和手术医生方面进行匹配。提取并比较相关的手术及结果数据。
7例孕期接受根治性子宫切除术的女性中，4例在平均孕周35.4周（范围32.3 - 38周）时行剖宫产根治性子宫切除术，3例在平均孕周14.2周时行根治性子宫切除术，胎儿仍存活于原位。两组的人口统计学特征相似。孕妇的输血率（57%）显著高于非孕妇对照组（9%）（p = 0.0009）。孕妇（43%）与非孕妇对照组（40%）的手术并发症总发生率相似（p = 无显著性差异）。
与非孕妇对照组相比，孕妇行根治性子宫切除术时失血更多，输血需求增加。两组在其他手术并发症方面未观察到差异。
