THE CLINICAL-SIGNIFICANCE OF UTERINE LEIOMYOMAS IN PREGNANCY
THE CLINICAL-SIGNIFICANCE OF UTERINE LEIOMYOMAS IN PREGNANCY
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DOI：
10.1016/0002-9378(89)90194-4
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发表时间：
1989-05-01
影响因子：
9.8
通讯作者：
MAHONY, BS
中科院分区：
文献类型：
--
作者：
RICE, JP;KAY, HH;MAHONY, BS
在对 1981 年至 1985 年间 6706 例妊娠的回顾性研究中，产前超声检查发现 93 例 (1.4%) 患者患有子宫肌瘤。对记录有平滑肌瘤的患者的产科记录和超声检查进行了审查，并与我们机构同期管理的匹配对照患者的数据进行了比较。在 93 例子宫肌瘤患者中，14 例（15.1%）在母体胎盘表面有 1 处或多处平滑肌瘤。值得注意的是，14 名胎盘后平滑肌瘤患者中有 8 名 (57%) 随后发生胎盘早剥，导致 4 名胎儿死亡。相反，在其余79名子宫肌瘤非胎盘后的患者中，只有两名患者（2.5%）发生胎盘早剥，且均未导致胎儿死亡。 93 名患者中有 14 名 (15.1%) 出现临床上明显的疼痛，需要麻醉镇痛，93 名患者中有 20 名 (21.5%) 发生早产；疼痛和早产与最大肌瘤的大小呈正相关。与没有记录的平滑肌瘤患者相比，患有平滑肌瘤的患者通过剖腹产和真空辅助分娩的发生率明显更高。在这个人群中，子宫肌瘤并没有显着改变宫内生长迟缓和低阿普加评分的发生率。
In a retrospective review of 6706 pregnancies between 1981 and 1985, uterine leiomyomas were documented by antenatal sonography in 93 (1.4%) patients. The obstetric records and sonograms of patients with documented leiomyomas were reviewed and compared with data from matched control patients managed at our institution during the same time period. Among the 93 patients with leiomyomas, 14 (15.1%) had one or more leiomyomas subjacent to the maternal surface of the placenta. Significantly, eight of 14 (57%) of these patients with retroplacental leiomyomas subsequently developed abruptio placentae, which resulted in the deaths of four fetuses. Conversely, among the remaining 79 patients whose leiomyomas were not retroplacental, abruptio placentae occurred in only two patients (2.5%), neither of which resulted in fetal death. Clinically significant pain requiring narcotic analgesia developed in 14 of 93 (15.1%) patients and premature labor occurred in 20 of 93 (21.5%); pain and premature labor correlated positively with the size of the largest myoma. Delivery by cesarean section and vacuum assistance occurred significantly more frequently in patients with leiomyomas than in those without documented leiomyomas. In this population uterine myomas did not significantly alter the incidence of intrauterine growth retardation and low Apgar scores.