Martin Jane, Ulrich Nicole D, Duplantis Sheena, Williams Frank B, Luo Qingyang, Moore Robert C
Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, Ochsner Clinic Foundation, New Orleans, Louisiana.
Office of Biostatistical Support, The Center for Applied Health Services Research, Ochsner Clinic Foundation, New Orleans, Louisiana.
Am J Perinatol. 2016 Oct;33(12):1218-22. doi: 10.1055/s-0036-1593389. Epub 2016 Sep 15.
Objective We aimed to determine if fibroids in pregnancy, categorized by size, are associated with adverse obstetrical outcomes. Study Design Demographic, clinical, and delivery data were collected from charts of women with singleton gestations who delivered at >20 weeks gestation with fibroids identified at routine anatomy scan and their randomly selected age-matched controls. Largest fibroid diameter was used to categorize small fibroids (≤5 cm) and large fibroids (>5 cm). Results We included 450 patients: 264 patients with fibroids (174 small, 90 large fibroids) and 186 age-matched controls. Women with large fibroids had significantly greater blood loss than women with small fibroids and women with no fibroids (p-value <0.0001 and <0.0001 after adjusting for delivery mode). When fibroid size was compared individually, there was a significantly higher rate of primary cesarean section in both small and large fibroid groups when compared with women with no fibroids (p-values 0.044 and 0.003 after adjusting for body mass index). Conclusion Women with fibroids in pregnancy have higher rates of primary cesarean delivery and are at significant risk for increased blood loss at the time of delivery.
我们旨在确定孕期肌瘤按大小分类是否与不良产科结局相关。
收集孕周大于20周、在常规解剖扫描中发现有肌瘤的单胎妊娠女性及其随机选择的年龄匹配对照的人口统计学、临床和分娩数据。最大肌瘤直径用于将小肌瘤（≤5 cm）和大肌瘤（>5 cm）分类。
我们纳入了450例患者：264例有肌瘤的患者（174例小肌瘤，90例大肌瘤）和186例年龄匹配的对照。有大肌瘤的女性比有小肌瘤的女性和无肌瘤的女性失血明显更多（调整分娩方式后p值<0.0001和<0.0001）。当分别比较肌瘤大小时，与无肌瘤的女性相比，小肌瘤组和大肌瘤组初次剖宫产率均显著更高（调整体重指数后p值分别为0.044和0.003）。
孕期有肌瘤的女性初次剖宫产率较高，且分娩时失血增加的风险显著。
