Ciavattini Andrea, Delli Carpini Giovanni, Clemente Nicolò, Moriconi Lorenzo, Gentili Chiara, Di Giuseppe Jacopo
Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy.
Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy.
Fertil Steril. 2016 May;105(5):1255-1260. doi: 10.1016/j.fertnstert.2016.01.032. Epub 2016 Feb 12.
To analyze the growth trend of small uterine fibroids during early pregnancy, evaluating the potential factors involved, with particular interest in hCG levels.
Observational study.
Tertiary care university hospital.
PATIENT(S): Women who had an ultrasound diagnosis of small myomas (diameter, ≥10 mm and ≤50 mm) from January 2007 to December 2013, and who subsequently became pregnant within 1 year.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Three additional ultrasound examinations were performed during early pregnancy (7-8, 10-13, and 20-22 complete gestational weeks, respectively) and the modifications in diameter and volume of each uterine fibroid were recorded. A serial evaluation of hCG serum levels from 5-12 weeks was performed.
RESULT(S): From the 109 women who fulfilled the study inclusion/exclusion criteria, a significant increase emerged, both for volume and diameter of the detected fibroids. Specifically, a median growth rate (GR) of 122% was observed during the interval of the first to the second ultrasound, whereas a median GR of 108% was detected during the interval between the second and the third ultrasound, and a median GR of 25% between the third and the fourth ultrasound. A significant positive correlation between hCG levels and diameter (R = 0.69) of myomas between 5 and 12 weeks emerged.
CONCLUSION(S): A remarkable nonlinear growth of small fibroids during initial pregnancy was observed, with a faster rate in the first trimester and a slowdown by midpregnancy. Those changes seem to be related to the similar increase of hCG levels until 12 weeks.
分析早孕期间小子宫肌瘤的生长趋势，评估相关潜在因素，尤其关注人绒毛膜促性腺激素（hCG）水平。
观察性研究。
三级护理大学医院。
2007年1月至2013年12月期间经超声诊断为小肌瘤（直径≥10 mm且≤50 mm），随后在1年内怀孕的女性。
无。
在早孕期间分别于7 - 8周、10 - 13周和20 - 22周进行了三次额外的超声检查，并记录每个子宫肌瘤直径和体积的变化。对5 - 12周的hCG血清水平进行了连续评估。
在符合研究纳入/排除标准的109名女性中，检测到的肌瘤体积和直径均显著增加。具体而言，在第一次超声检查到第二次超声检查期间，观察到的中位生长率（GR）为122%，而在第二次超声检查到第三次超声检查期间，中位GR为108%，在第三次超声检查到第四次超声检查期间，中位GR为25%。在5至12周之间，hCG水平与肌瘤直径之间存在显著正相关（R = 0.69）。
观察到早孕期间小肌瘤有显著的非线性生长，孕早期生长速度较快，到孕中期减缓。这些变化似乎与12周前hCG水平的类似升高有关。
