Department of Gynaecology, Third Xiangya Hospital, Central South University, Changsha, China.
Department of Anesthesiology and National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
Int J Hyperthermia. 2021;38(1):79-84. doi: 10.1080/02656736.2021.1874547.
The aim of this study was to retrospectively compare and analyze pregnancy outcomes of patients with uterine fibroids after high intensity focused ultrasound (HIFU) ablation and laparoscopic myomectomy (LM).
The study group consisted of 346 patients with uterine fibroids who wished to conceive, in which 152 patients received HIFU ablation treatment (HIFU group) and 194 patients received LM treatment (LM group). The parents' baseline characters were recorded and the pregnancy outcomes were evaluated in a median follow-up time of 42 months (range: 16 ∼ 81) after the treatment, and the differences of the two groups were compared.
Patients with uterine fibroids in HIFU group had a significant shorter pregnancy interval than that in LM group (10 months 13 months, < .05). No significant differences were observed in pregnancy rate, miscarriage rate, live birth rate, natural pregnancy rate, cesarean section rate, and perinatal complications rate between the HIFU group and the LM group ( > .05). When stratified by age, infertility history, fibroid types, fibroid numbers, and fibroid sizes, there was no statistically significant difference in pregnancy rate between the HIFU group and the LM group ( > .05).
Based on the results from this study, both HIFU and LM can be safely used to treat patients who wish to conceive. The pregnancy outcomes of post-HIFU are similar to that of post-LM.
本研究旨在回顾性比较和分析高强度聚焦超声（HIFU）消融与腹腔镜子宫肌瘤切除术（LM）治疗后子宫肌瘤患者的妊娠结局。
研究组纳入 346 例有生育要求的子宫肌瘤患者，其中 152 例接受 HIFU 消融治疗（HIFU 组），194 例接受 LM 治疗（LM 组）。记录父母的基本特征，在治疗后中位数 42 个月（范围：16 ～ 81）的随访时间内评估妊娠结局，并比较两组间的差异。
HIFU 组患者的妊娠间隔明显短于 LM 组（10 个月 13 个月， < .05）。HIFU 组和 LM 组的妊娠率、流产率、活产率、自然妊娠率、剖宫产率和围生期并发症率差异均无统计学意义（ > .05）。按年龄、不孕史、肌瘤类型、肌瘤数量和肌瘤大小分层后，HIFU 组和 LM 组的妊娠率差异无统计学意义（ > .05）。
根据本研究结果，HIFU 和 LM 均可安全用于有生育要求的患者。HIFU 治疗后的妊娠结局与 LM 治疗后相似。
