Allameh Zahra, Allameh Tajossadat
Department of Obstetrics and Gynecology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2019 Sep 30;8:60. doi: 10.4103/abr.abr_236_18. eCollection 2019.
The prevalence of uterine myomas during pregnancy is estimated to be small. However, a significant fraction of these could lead to pregnancy complications. Myomectomy is rarely performed during pregnancy because of fear of miscarriage and the risk of uncontrolled hemorrhage necessitating hysterectomy. This article reports on a case of myomectomy of subserous leiomyoma that was causing septic necrosis, leukocytosis, rise of inflammatory markers (erythrocyte sedimentation rate and C-reactive protein), and pressure symptom on the liver. Myomectomy was performed at 20 weeks of gestation. The pregnancy continued with no further problems, and at 39 weeks and 1 day of gestation, vaginal delivery resulted in a healthy baby. It is postulated that when myomectomy is performed in carefully selected patients, it prevents sepsis due to myoma torsion and necrosis and also protects surrounding organs against damage.
据估计，孕期子宫肌瘤的患病率较低。然而，其中相当一部分可能导致妊娠并发症。由于担心流产以及存在因无法控制的出血而需要进行子宫切除术的风险，孕期很少进行肌瘤切除术。本文报道了一例浆膜下平滑肌瘤肌瘤切除术病例，该肌瘤导致了感染性坏死、白细胞增多、炎症标志物（红细胞沉降率和C反应蛋白）升高以及对肝脏的压迫症状。肌瘤切除术在妊娠20周时进行。妊娠继续进行且未出现进一步问题，在妊娠39周零1天时，经阴道分娩产下一名健康婴儿。据推测，在经过精心挑选的患者中进行肌瘤切除术时，可预防肌瘤扭转和坏死引起的败血症，并保护周围器官免受损害。
