Radhika B H, Naik Kusuma, Shreelatha S, Vana Harshini
Senior Resident, Department of Obstetrics and Gynecology, ESI Post Graduate Institute of Medical Science and Research , Bangalore, India .
Assistant Professor, Department of Obstetrics and Gynecology, ESI Post Graduate Institute of Medical Science and Research , Bangalore, India .
J Clin Diagn Res. 2015 Oct;9(10):QR01-4. doi: 10.7860/JCDR/2015/14375.6621. Epub 2015 Oct 1.
Fibroids in pregnancy is a commonly encountered clinical entity. Objective of this study was to evaluate the maternal and fetal outcome in women having pregnancy with uterine fibroids. We present the clinical, obstetric data, perinatal outcomes of 15 patients from a prospective study. Fifteen pregnant women with fibroid >3cm were prospectively included in study. Major proportion of patient with fibroids were in younger age group of 25-30 years when compared to older age group of 31-35 years (66% vs 33%). Fibroids were more frequent in multi-gravidae, compared to primigravidae. In almost half of patients, (53.3%) fibroids were diagnosed before pregnancy. Common complications encountered during pregnancy in decreasing order of frequency were pain abdomen (46.6%), followed by threatened preterm labour (26.6%) and anaemia (26.6%). Out of 15, three (20%) women had abortion. In remaining, 11/12 patients attained term pregnancy between 37 to 40 weeks. Two patients required antenatal myomectomy. Caesarean section was done in 75% of women who attained term pregnancy and one patient had technical difficulty during caesarean section. Post partum heamorrhage was seen in 5/15 (33.3%) of patients. Out of 12, five babies were low birth weight. Four babies required NICU admission. There was no perinatal mortality. In our small patient series high incidence of caesarean section rates and increased incidence of threatened preterm labour, anaemia, and postpartum haemorrhage, was observed in pregnant patients with fibroids and hence, the pregnancy with fibroids should be considered as high risk pregnancy.
孕期子宫肌瘤是一种常见的临床病症。本研究的目的是评估患有子宫肌瘤的孕妇的母儿结局。我们展示了一项前瞻性研究中15例患者的临床、产科数据及围产期结局。15例肌瘤直径>3cm的孕妇被前瞻性纳入研究。与31 - 35岁的年龄组相比,肌瘤患者的主要比例处于25 - 30岁的较年轻年龄组(66%对33%)。与初产妇相比,经产妇的肌瘤更为常见。几乎一半的患者(53.3%)在怀孕前被诊断出患有肌瘤。孕期常见并发症按发生频率从高到低依次为腹痛(46.6%),其次是先兆早产(26.6%)和贫血(26.6%)。15例患者中有3例(20%)发生流产。其余11/12例患者孕周达到37至40周足月妊娠。2例患者需要进行产前肌瘤切除术。足月妊娠的女性中有75%进行了剖宫产,1例患者在剖宫产时遇到技术困难。15例患者中有5例(33.3%)出现产后出血。12例中有5例婴儿出生体重低。4例婴儿需要入住新生儿重症监护病房。无围产儿死亡。在我们这个小样本患者系列中,观察到患有肌瘤的孕妇剖宫产率高,先兆早产、贫血和产后出血的发生率增加,因此,肌瘤合并妊娠应被视为高危妊娠。