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孕期子宫肌瘤:病例系列

Fibroids in Pregnancy: A Case Series.

作者信息

Amber Sofia, Fahad Asma, Maqbool Sadia, Aftab Nighat, Faraz Saima

机构信息

Obstetrics and Gynaecology, Latifa Women and Children Hospital, Dubai, ARE.

Obstetrics and Gynaecology, Dubai Academic Health Corporation, Dubai, ARE.

出版信息

Cureus. 2025 Jul 9;17(7):e87577. doi: 10.7759/cureus.87577. eCollection 2025 Jul.

Abstract

Uterine fibroids are common benign tumors that can complicate pregnancy by affecting maternal and fetal outcomes. The impact depends on fibroid size, number, and location. This case series aims to highlight clinical outcomes in pregnancies complicated by fibroids. Three pregnant women with known uterine fibroids were followed through antenatal, intrapartum, and postpartum periods at a tertiary care hospital. Maternal demographics, fibroid characteristics, pregnancy complications, mode of delivery, and neonatal outcomes were reviewed. All patients conceived spontaneously and were diagnosed with fibroids between early pregnancy and the second trimester. Fibroid sites included the cervix, anterior lower uterine segment, and anterior/posterior subserosal regions, with sizes ranging from 4.4×4.5 cm to 12×11.2 cm. All deliveries were conducted by lower-segment cesarean section between 35 and 36 weeks of gestation. Two neonates required NICU admission for respiratory distress, though no cases of birth asphyxia were reported. Intraoperative difficulties were encountered mainly in cases with cervical fibroids. Maternal outcomes were favorable with no major postoperative complications. It is concluded that fibroids in pregnancy, particularly those that are large or lower-segment located, increase the risk of preterm birth and cesarean delivery. Careful antenatal monitoring and individualized delivery planning are essential to optimize maternal and neonatal outcomes.

摘要

子宫肌瘤是常见的良性肿瘤,可通过影响母婴结局使妊娠复杂化。其影响取决于肌瘤的大小、数量和位置。本病例系列旨在突出肌瘤合并妊娠的临床结局。在一家三级医院对三名已知患有子宫肌瘤的孕妇进行了产前、产时和产后随访。回顾了产妇人口统计学资料、肌瘤特征、妊娠并发症、分娩方式和新生儿结局。所有患者均自然受孕,在孕早期至孕中期之间被诊断出患有肌瘤。肌瘤部位包括宫颈、子宫下段前部以及浆膜下前/后区域,大小从4.4×4.5厘米至12×11.2厘米不等。所有分娩均在妊娠35至36周之间通过下段剖宫产进行。两名新生儿因呼吸窘迫需要入住新生儿重症监护病房,不过未报告有出生窒息病例。术中困难主要出现在宫颈肌瘤病例中。产妇结局良好,无重大术后并发症。结论是,妊娠合并肌瘤,尤其是那些较大或位于下段的肌瘤,会增加早产和剖宫产的风险。仔细的产前监测和个性化的分娩计划对于优化母婴结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca32/12334970/e41ee3fe0481/cureus-0017-00000087577-i01.jpg

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