Tamura Hiroshi, Kishi Hiroshi, Kitade Mari, Asai-Sato Mikiko, Tanaka Atsushi, Murakami Takashi, Minegishi Takashi, Sugino Norihiro
Department of Obstetrics and Gynecology Yamaguchi University Graduate School of Medicine Ube Japan.
Department of Obstetrics and Gynecology Gunma University Graduate School of Medicine Maebashi Japan.
Reprod Med Biol. 2017 Aug 21;16(4):330-336. doi: 10.1002/rmb2.12050. eCollection 2017 Oct.
To investigate the impact of adenomyosis on the complications and outcomes of pregnancy in Japan.
We carried out a multicenter retrospective questionnaire survey. A questionnaire regarding pregnancy complications and the outcomes of pregnancy was sent to 725 facilities.
Data were obtained on the cases of 272 pregnant women with adenomyosis from 65 facilities. The complications of pregnancy included miscarriage before 12 weeks of pregnancy (14.8%), miscarriage after 12 weeks of pregnancy (9.9%), preterm delivery (24.4%), fetal growth restriction (11.8%), pregnancy-induced hypertension (9.9%), intrauterine infection (7.3%), and cervical incompetency (5.3%). The rates of pregnancy complications in the three groups classified according to pretreatment for adenomyosis (no pretreatment, medication, surgery) did not differ to a statistically significant extent. The rates of miscarriage (>12 weeks) and cervical incompetency increased according to the size of the adenomyosis. The rates of pregnancy-induced hypertension and uterine infection in patients with diffuse-type adenomyosis were higher than that in patients with focal-type adenomyosis.
Our results show that the increased size and diffuse type of adenomyosis are associated with adverse pregnancy outcome. We should be aware of the higher incidence of pregnancy-induced hypertension and uterine infection in patients with diffuse-type adenomyosis.
调查子宫腺肌病对日本妊娠并发症及妊娠结局的影响。
我们开展了一项多中心回顾性问卷调查。向725家机构发送了一份关于妊娠并发症及妊娠结局的问卷。
从65家机构获取了272例子宫腺肌病孕妇的病例数据。妊娠并发症包括妊娠12周前流产（14.8%）、妊娠12周后流产（9.9%）、早产（24.4%）、胎儿生长受限（11.8%）、妊娠期高血压（9.9%）、宫内感染（7.3%）以及宫颈机能不全（5.3%）。根据子宫腺肌病治疗前情况（未治疗、药物治疗、手术治疗）分类的三组患者的妊娠并发症发生率在统计学上无显著差异。流产（>12周）和宫颈机能不全的发生率随子宫腺肌病大小增加而升高。弥漫型子宫腺肌病患者的妊娠期高血压和子宫感染发生率高于局灶型子宫腺肌病患者。
我们的结果表明，子宫腺肌病增大的体积和弥漫型与不良妊娠结局相关。我们应意识到弥漫型子宫腺肌病患者妊娠期高血压和子宫感染的发生率较高。
