Department of Gynecology and Obstetrics, Ningbo Women and Children's Hospital, 339 Liuting Street, Haishu District, Ningbo, Zhejiang, 315000, China.
Department of Internal Medicine, Ningbo Urology & Nephrology Hospital, Ningbo, 315000, China.
BMC Womens Health. 2024 Jan 2;24(1):7. doi: 10.1186/s12905-023-02852-9.
In this study, the prognostic and reproductive outcomes of women who underwent excision of uterine myomas and were sutured using different techniques while undergoing a cesarean section were investigated.
A total of 299 females who underwent cesarean section between January 2015 and June 2022 due to a scarred uterus were enrolled in this study. These participants were segregated into two categories: the experimental group (comprising 155 cases) in which uterine myoma (single lesion) was excised during the cesarean procedure, and the control group (consisting of 144 cases) in which only the cesarean section was conducted. A comparison between the two groups was carried out based on the following parameters: volume of intraoperative bleeding (mL), additional measures taken for intraoperative hemostasis (n, %), percentage (%) of patients experiencing postoperative fever, duration required for the passage of gas (hours [h]), length of hospital stay (days [d]), weight of newborns (kg) and their Apgar scores, and the reproductive outcomes of the experimental group assessed two years after the surgical procedure.
In the experimental group, the amount of bleeding during surgery, occurrence of postoperative fever among women, time taken for patients to resume passing gas, and length of hospital stay were 540.65 ± 269.12 mL, 9.03%, 15.99 ± 4.68 h, and 5.08 ± 1.18 days, respectively. In contrast, the control group had values of 409.03 ± 93.24 mL, 2.77%, 16.24 ± 4.92, and 4.47 ± 0.70 days, respectively (P < 0.05). No notable increase was observed in the need for additional intraoperative hemostasis measures, and there was no significant difference in the time it took for patients to pass gas after the surgery. All newborns had positive health status. In the experimental group, 25 patients underwent subsequent pregnancies, and 15 of them successfully reached full-term deliveries, all of which had positive outcomes.
Combining myomectomy with various suture methods during cesarean delivery did not cause excessive bleeding and resulted in healthy newborns. This approach offers the advantage of avoiding additional surgeries under anesthesia and can be considered a viable option. Subsequent pregnancies after myomectomy were considered high-risk.
本研究旨在探讨因瘢痕子宫而行剖宫产术的患者中，采用不同缝合技术切除子宫肌瘤的预后和生殖结局。
回顾性分析 2015 年 1 月至 2022 年 6 月期间因瘢痕子宫行剖宫产术的 299 例女性患者的临床资料，将其分为两组：实验组（155 例）行剖宫产术时切除单个子宫肌瘤，对照组（144 例）仅行剖宫产术。比较两组术中出血量（mL）、术中额外止血措施（n，%）、术后发热患者比例（%）、肛门排气时间（h）、住院时间（d）、新生儿体重（kg）及 Apgar 评分、实验组患者术后 2 年的生殖结局。
实验组术中出血量、术后发热患者比例、肛门排气时间、住院时间分别为 540.65±269.12mL、9.03%、15.99±4.68h、5.08±1.18d，对照组分别为 409.03±93.24mL、2.77%、16.24±4.92h、4.47±0.70d，差异有统计学意义（P<0.05）。实验组患者术中额外止血措施的需求无明显增加，术后肛门排气时间无明显差异。所有新生儿均健康。实验组 25 例患者后续妊娠，15 例成功足月分娩，均结局良好。
剖宫产术时联合应用各种缝合技术切除子宫肌瘤并不会导致明显出血，且新生儿健康状况良好。该方法避免了再次麻醉下手术，是一种可行的选择。但肌瘤切除术后的再次妊娠被认为是高危妊娠。
