Orsi Michele, Somigliana Edgardo, Cribiù Fulvia Milena, Lopez Gianluca, Buggio Laura, Ossola Manuela Wally, Ferrazzi Enrico
Department of Woman, New-Born and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda, 12, 20122 Milan, Italy.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy.
J Clin Med. 2022 Aug 17;11(16):4814. doi: 10.3390/jcm11164814.
The epidemiology of adenomyosis has been traditionally based on patients undergoing hysterectomy for gynecological indications, while its prevalence among hysterectomies performed for obstetric complications is unknown. The aim of this study was to assess the prevalence and clinical impact of adenomyosis diagnosed through histology among women undergoing pregnancy-related hysterectomy (PH).
This was a retrospective cohort study. Women who delivered at a tertiary care regional obstetric hub in Milan between 2009 and 2020 were reviewed to identify cases of PH. Histopathological reports of surgical specimens were examined. Cases with adenomyosis were compared to those without adenomyosis for baseline characteristics, obstetric history and outcomes.
During the study period there were 71,061 births and a total of 130 PH, giving a PH incidence of 1.83 per 1000 deliveries. Adenomyosis cases were 18, giving a prevalence of 13.8%. Adenomyosis was associated with placenta previa (77.8 vs. 45.5%, = 0.01), chorionamnionitis (27.8 vs. 5.4%, = 0.008), lower gestational age at birth (32 ± 4.6 vs. 35.5 ± 3.6 weeks' gestation, = 0.0004), and intrauterine fetal demise among twin pregnancies (50 vs. 4.5%, = 0.048).
Adenomyosis entails a relevant impact on obstetric and perinatal outcomes related to PH. More evidence is needed on the clinical relevance of an ultrasonographic diagnosis of adenomyosis before conception.
子宫腺肌病的流行病学传统上基于因妇科指征接受子宫切除术的患者，而其在因产科并发症进行的子宫切除术中的患病率尚不清楚。本研究的目的是评估在接受与妊娠相关子宫切除术（PH）的女性中通过组织学诊断的子宫腺肌病的患病率及其临床影响。
这是一项回顾性队列研究。对2009年至2020年期间在米兰一家三级护理区域产科中心分娩的女性进行回顾，以确定PH病例。检查手术标本的组织病理学报告。将子宫腺肌病病例与无子宫腺肌病病例的基线特征、产科病史和结局进行比较。
在研究期间，共有71061例分娩，130例PH，PH发病率为每1000例分娩1.83例。子宫腺肌病病例18例，患病率为13.8%。子宫腺肌病与前置胎盘（77.8%对45.5%，P = 0.01）、绒毛膜羊膜炎（27.8%对5.4%，P = 0.008）、出生时孕周较小（32±4.6周对35.5±3.6周，P = 0.0004）以及双胎妊娠中的胎儿宫内死亡（50%对4.5%，P = 0.048）相关。
子宫腺肌病对与PH相关的产科和围产期结局有显著影响。关于受孕前超声诊断子宫腺肌病的临床相关性，还需要更多证据。
