妊娠有蒂平滑肌瘤症状回顾及一例病例的特别考量
Review on Symptomatic pedunculated leiomyomas in pregnancy with special consideration of an example case.
作者信息
Bubmann Jonas, Wild Carl Mathis, Dannecker Christian, Franitza Manuela, Eser Bernadette, Seefried Marina C, Kroencke Thomas, Voisard Philipp, Jeschke Udo, Garrido Fabian
机构信息
Gynecology, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
Bayerisches Zentrum für Krebsforschung (BZKF), Partnerstandort Augsburg, Augsburg, Germany.
出版信息
Arch Gynecol Obstet. 2025 Jun;311(6):1543-1552. doi: 10.1007/s00404-024-07840-4. Epub 2024 Nov 27.
OBJECTIVES/HYPOTHESIS: Symptomatic pedunculated leiomyomas in pregnancy; review of the literature with special consideration of an example case.
STUDY DESIGN
Retrospective narrative review with an example case.
METHODS
Systematic evaluation of 37 reports.
EXAMPLE CASE
A 36-year-old Caucasian primigravida was referred symptomatic at 16 + 0 weeks due to a 13,5 cm myoma causing pain, constipation, urine retention and dysesthesias. Our patient underwent myomectomy at 17 + 0 weeks. One pedunculated leiomyoma was successfully removed.
CONCLUSION
Myomectomy can be performed and is safe for pedunculated fibroids in pregnancy. Depending on the clinical scenario, surgical removal may be indicated. Based on the size of the fibroids and expected adhesions, a laparotomy is a safe option and is not a contraindication for vaginal birth in the case of pedunculated fibroids. Myomas larger than 10 cm should be removed by laparotomy.
目的/假设：妊娠期间有症状的带蒂平滑肌瘤；结合一个实例病例对文献进行综述。
研究设计
结合一个实例病例的回顾性叙述性综述。
方法
对37份报告进行系统评估。
实例病例
一名36岁的白种人初产妇，孕16⁺⁰周时因一个13.5厘米的肌瘤出现疼痛、便秘、尿潴留和感觉异常等症状前来就诊。我们的患者在孕17⁺⁰周时接受了肌瘤切除术。成功切除了一个带蒂平滑肌瘤。
结论
妊娠期间带蒂肌瘤可行肌瘤切除术且安全。根据临床情况，可能需要手术切除。根据肌瘤大小和预期粘连情况，剖腹手术是一种安全选择，对于带蒂肌瘤而言并非经阴道分娩的禁忌证。大于10厘米的肌瘤应通过剖腹手术切除。
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