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高强度聚焦超声治疗原发性不孕腺肌病患者的妊娠结局。

Pregnancy outcomes of adenomyotic patients with primary infertility after high-intensity focused ultrasound treatment.

机构信息

State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.

Department of Gynaecology and Obstetrics of Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.

出版信息

Int J Hyperthermia. 2023;40(1):2264547. doi: 10.1080/02656736.2023.2264547. Epub 2023 Oct 30.

Abstract

OBJECTIVE

To evaluate the therapeutic effect of high-intensity focused ultrasound (HIFU) treatment for adenomyotic patients with primary infertility and to explore the factors that affect the pregnancy outcomes.

MATERIALS AND METHODS

Twenty-seven adenomyotic patients with primary infertility who underwent HIFU at HUNAN Provincial Maternal and Child Health Care Hospital, China, between July 2018 and December 2022 were retrospectively reviewed. We evaluated the pregnancy outcomes and analyzed the factors that may affect pregnancy outcomes including time to conception, pregnancy approach, gestational age, delivery mode, neonatal outcomes, and complications during pregnancy and delivery.

RESULTS

Among the 27 adenomyotic patients with primary infertility, 10 patients had a total of 11 pregnancies after HIFU treatment. Of these, eight (72%) cases were natural pregnancies and three (23%) were fertilization (IVF) pregnancies. The median time to conception was 10 (range 4-25) months. There were eight (72%) successful deliveries. The rate of full-term deliveries was 90%. Of the eight live births, four (50%) were born vaginally and four (50%) by cesarean section. No severe complications occurred. The mean birth weight of newborns was 3.1 (range: 2.3-3.9) kg; all newborns developed well without complications during postpartum and breastfeeding.

CONCLUSIONS

HIFU treatment for adenomyosis could improve fertility of patients with primary infertility. HIFU is a promising therapeutic approach for patients with adenomyosis and infertility who wish to achieve pregnancy and have live birth deliveries.

摘要

目的

评估高强度聚焦超声(HIFU)治疗原发性不孕腺肌病患者的疗效,并探讨影响妊娠结局的因素。

材料与方法

回顾性分析 2018 年 7 月至 2022 年 12 月在湖南省妇幼保健院接受 HIFU 治疗的 27 例原发性不孕腺肌病患者。评估妊娠结局,并分析可能影响妊娠结局的因素,包括受孕时间、妊娠方式、胎龄、分娩方式、新生儿结局以及妊娠和分娩期间的并发症。

结果

27 例原发性不孕腺肌病患者中,10 例患者 HIFU 治疗后共妊娠 11 次。其中 8 例(72%)为自然妊娠,3 例(23%)为体外受精(IVF)妊娠。受孕时间中位数为 10(范围 4-25)个月。8 例成功分娩,足月分娩率为 90%。8 例活产儿中,4 例(50%)经阴道分娩,4 例(50%)剖宫产。无严重并发症发生。新生儿平均出生体重为 3.1(范围:2.3-3.9)kg;所有新生儿均发育良好,产后及母乳喂养期间无并发症。

结论

HIFU 治疗腺肌病可改善原发性不孕患者的生育能力。HIFU 是一种有前途的治疗方法,适用于希望妊娠并获得活产的腺肌病和不孕患者。

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