子宫肌瘤的双胎妊娠并不会增加产科并发症的风险：单中心队列研究。
Twin pregnancies with uterine fibroids are not at increased risk for obstetric complications: single center cohort study.
机构信息
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, 566, Nonhyeon-ro, Gangnam-gu, Seoul, 135-081, Republic of Korea.
College of General Education, Kookmin University, Seoul, Republic of Korea.
出版信息
BMC Pregnancy Childbirth. 2020 Apr 15;20(1):222. doi: 10.1186/s12884-020-02908-w.
BACKGROUND
Twin pregnancies with uterine fibroid(s) (UFs) may not be at increased risk for obstetric complications compared to those without UFs. However, there was no reported comparison study with obstetric outcomes and complications of twin pregnancy after myomectomy. We aimed to compare the pregnancy outcomes in twin pregnancies with or without uterine fibroid(s), and also compared in patients with previous myomectomy history in Korean women.
METHODS
A cohort of twin pregnancies delivered in a single institution between January 2011 and March 2019 were retrospectively analyzed. UFs group was defined by the presence of UFs during pregnancy (≥1 fibroid, measuring ≥2 cm or multiple fibroids regardless of the size). Previous myomectomy group included patients with history of abdominal or laparoscopic or hysteroscopic myomectomy of ≥1 fibroid, measuring ≥2 cm or multiple fibroids whatever the size. Patients with monochorionic monoamniotic twins, myoma less than 2 cm in size, missed abortion or intrauterine fetal death (IUFD) of one fetus before 14 weeks, history of previous conization, and uterine anomalies were excluded. Pregnancy outcomes and obstetric complications were compared.
RESULT
A total 1388 patients were included in this study, 191 (13.8%) had UFs and 89 (6.4%) had a history of myomectomy. Maternal age was younger in non-UFs group and primiparity was more common in UFs group (p < 0.001, and p = 0.019). No significant differences were found in the gestational age at delivery (p = 0.657), delivery before 37 weeks (p = 0.662), delivery before 34 weeks (p = 0.340), and sum of birth weight of twin (p = 0.307). There were also no statistical differences in rates of obstetrical complications, such as preeclampsia, gestational diabetes mellitus, placenta previa, placenta abruption, cerclage, small for gestational age, IUFD, postpartum hemorrhage and peripartum transfusion or ICU care. These obstetrical outcomes and complications showed no statistical differences between UFs group and previous myomectomy group.
CONCLUSION
In patients with twin pregnancies, the presence of UFs or history of previous myomectomy did not relate to negative effects on pregnancy outcomes and obstetrical complications.
背景
与无子宫肌瘤（UFs）的双胎妊娠相比，多发性子宫肌瘤的双胎妊娠可能不会增加产科并发症的风险。然而，目前还没有关于子宫肌瘤剔除术后双胎妊娠的产科结局和并发症的比较研究报告。我们旨在比较韩国女性有或无子宫肌瘤的双胎妊娠的妊娠结局，并比较既往有子宫肌瘤剔除术史的患者。
方法
回顾性分析 2011 年 1 月至 2019 年 3 月在一家机构分娩的双胎妊娠病例。UFs 组定义为妊娠期间存在 UFs（≥1 个肌瘤，直径≥2cm 或多个肌瘤，无论大小）。既往子宫肌瘤剔除术组包括既往有≥1 个肌瘤（直径≥2cm 或多个肌瘤，无论大小）行腹式、腹腔镜或宫腔镜子宫肌瘤剔除术的患者。排除单绒毛膜单羊膜双胎、肌瘤直径＜2cm、妊娠 14 周前失胎或胎儿宫内死亡（IUFD）、宫颈锥切术史、子宫畸形的患者。比较妊娠结局和产科并发症。
结果
本研究共纳入 1388 例患者，其中 191 例（13.8%）存在 UFs，89 例（6.4%）有子宫肌瘤剔除术史。非 UFs 组的产妇年龄较小，UFs 组初产妇较多（p＜0.001，p=0.019）。两组的分娩孕周（p=0.657）、37 周前分娩（p=0.662）、34 周前分娩（p=0.340）、双胎出生体重总和（p=0.307）差异均无统计学意义。两组产科并发症发生率如子痫前期、妊娠期糖尿病、前置胎盘、胎盘早剥、宫颈环扎术、小于胎龄儿、IUFD、产后出血、围产输血或 ICU 治疗也无统计学差异。UFs 组和既往子宫肌瘤剔除术组的这些产科结局和并发症差异均无统计学意义。
结论
在双胎妊娠患者中，UFs 的存在或既往有子宫肌瘤剔除术史与妊娠结局和产科并发症无关。
Zotero 插件