Fuchs Anna, Dulska Agnieszka, Sikora Jerzy, Czech Iwona, Skrzypulec-Plinta Violetta, Drosdzol-Cop Agnieszka
Department of Pregnancy Pathology, Department of Woman's Health, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Department of Woman's Health, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Ginekol Pol. 2019;90(6):320-324. doi: 10.5603/GP.2019.0058.
Uterine fibroids are one of the most common benign tumors of the female genital tract. The major complication of myomas in pregnancy is a recurrent pain, however the misscariage is the main threat. The negative impact of myomas on the course of pregnancy may also result in i.e. uterine bleeding, higher incidence of a maternal-fetal incommunicability, an incorrect position of the fetus and its deformities.
The patient aged 31 was admitted to Mother and Child Health Center in Zabrze due to the threatened miscarriage. The primigravid at 19 weeks' gestation was previously diagnosed with myoma. On admission the ultrasonography revealed one alive fetus in the uterus and a nodular change on the right side of the uterine fundus, 13 x 11 cm in size and non-homogenous echo.
The patient was qualified to the conservative myomectomy. 11 days after the enucleation of 25 cm in diameter myoma, patient in good condition, with the maintained, alive foetus was discharged from the hospital. Patient at 34 weeks' gestation was re-admitted due to the beginning of uterine contraction. After one week of observation within the ward, with tocolytic drugs and steroids administered, at 35th week of pregnancy the patient gave birth to a live daughter via the Ceasarian section.
Prenatal myomectomy can be safely performed in the first and second trimester of pregnancy, however it is recommended to deliver the baby via Caesarean section, due to fear of intrauterine rupture of the uterus.
子宫肌瘤是女性生殖道最常见的良性肿瘤之一。肌瘤在妊娠期间的主要并发症是反复疼痛，然而流产是主要威胁。肌瘤对妊娠过程的负面影响还可能导致子宫出血、母婴沟通障碍发生率增加、胎儿位置异常及其畸形等。
一名31岁患者因先兆流产入住扎布热母婴健康中心。这位初产妇妊娠19周，此前被诊断出患有肌瘤。入院时超声检查显示子宫内有一个存活胎儿，子宫底部右侧有一个结节性改变，大小为13×11厘米，回声不均匀。
患者符合保守性子宫肌瘤切除术的条件。在摘除直径25厘米的肌瘤11天后，患者情况良好，胎儿存活，随后出院。妊娠34周时，患者因子宫收缩开始再次入院。在病房观察一周，使用了宫缩抑制剂和类固醇后，妊娠35周时患者通过剖宫产分娩出一个活女婴。
产前子宫肌瘤切除术可在妊娠的第一和第二孕期安全进行，但由于担心子宫内破裂，建议通过剖宫产分娩。
