Vergani P, Ghidini A, Strobelt N, Roncaglia N, Locatelli A, Lapinski R H, Mangioni C
Department of Obstetrics and Gynecology, III Branch of the University of Milan, Ospedale San Gerardo, Monza, Italy.
Am J Perinatol. 1994 Sep;11(5):356-8. doi: 10.1055/s-2007-994554.
To evaluate the clinical significance of the presence, location, size, and number of uterine leiomyomas in pregnancy, a retrospective cohort study in which pregnancy complications and outcome of pregnant women with uterine myomas was undertaken by routine second trimester ultrasound examination. The case group consisted of 183 consecutive women with uterine myomas detected and followed during the years 1983-1989; the control group was made up of all pregnancies diagnosed and followed at the obstetric clinic during the period 1985-1987. The incidences of preterm delivery (less than 37 weeks), preterm premature rupture of membranes, in utero growth retardation (less than 5th percentile), placental abruptio, placenta previa, postpartum hemorrhage (more than 500 cc), and retained placenta were not significantly increased in the group of women with myomas compared with the general population. However, cesarean sections were more common in women with myomas (23 vs 12%; P < 0.001). Within the group of women with myomas, the incidence of cesarean section was not different in cases with multiple rather than solitary myomas, but it was significantly higher in cases of lower uterine segment compared with fundal myomas (39 vs 18%; P < 0.01) and when the mean diameter of the myoma was greater than 5 cm (35 vs 17%; P = 0.01). Stepwise logistic regression analysis showed that both myoma location and size were independent predictors of the odds of cesarean section.
为评估妊娠期间子宫平滑肌瘤的存在、位置、大小和数量的临床意义，进行了一项回顾性队列研究，通过常规孕中期超声检查对患有子宫肌瘤的孕妇的妊娠并发症及结局进行研究。病例组由1983年至1989年期间连续检测并随访的183例患有子宫肌瘤的女性组成；对照组由1985年至1987年期间在产科门诊诊断并随访的所有妊娠组成。与普通人群相比，肌瘤组孕妇的早产（小于37周）、胎膜早破、胎儿宫内生长受限（小于第5百分位数）、胎盘早剥、前置胎盘、产后出血（超过500毫升）和胎盘残留的发生率并未显著增加。然而，肌瘤组女性剖宫产更为常见（23%对12%；P<0.001）。在肌瘤组女性中，多发性肌瘤而非单发性肌瘤的剖宫产发生率并无差异，但子宫下段肌瘤的剖宫产发生率显著高于子宫底部肌瘤（39%对18%；P<0.01），且肌瘤平均直径大于5厘米时剖宫产发生率也显著更高（35%对17%；P = 0.01）。逐步逻辑回归分析表明，肌瘤位置和大小均是剖宫产几率的独立预测因素。
