子宫肌瘤患者孕产时并发症、分娩结局及新生儿结局分析  

Complications,Pregnancy and Neonatal Outcome of Patients with Uterine Fibroids

作　　者：薛智方 吴跃芹[1] 王细先[1] 游建群 XUE Zhifang;WU Yueqin;WANG Xixian;YOU Jianqun(Department of Gynecology and Obstetrics,Beijing Aerospace Hospital,Beijing 100076,China)

机构地区：[1]北京航天总医院妇产科,北京100076

出　　处：《医学综述》2018年第22期4573-4576,共4页Medical Recapitulate

摘　　要：目的探讨子宫肌瘤对妊娠和新生儿结局的影响。方法选择2015年12月至2017年12月北京航天总医院收治的382例妊娠合并子宫肌瘤患者为研究组,选择同期收治的382例无子宫肌瘤的待产孕妇为对照组,对比两组患者在孕产各期并发症、产科结局及新生儿情况的差异。结果研究组先兆流产、先兆早产、胎位异常、前置胎盘发生率、产后出血率均高于对照组[12. 0%(45/382)比2. 8%(11/382),6. 0%(22/382)比1. 0%(4/382),11. 2%(43/382)比2. 6%(10/382),14. 1%(54/382)比3. 9%(15/382),10. 7%(41/382)比3. 4%(13/382)](P <0. 01),两组胎膜早破和胎盘早剥的发生率比较差异无统计学意义(P> 0. 05)。研究组剖宫产率显著高于对照组[66. 2%(253/382)比33. 0%(126/382)](P <0. 01)。研究组胎儿窘迫、低出生体重儿的发生率均高于对照组[5. 5%(21/382)比1. 3%(5/382),11. 0%(42/382)比2. 9%(11/382)](P <0. 01)。两组在新生儿窒息和胎儿畸形的发生率比较,差异无统计学意义(P> 0. 05)。结论子宫肌瘤在一定程度上增加了妊娠各期并发症、不良分娩结局及新生儿不良结局的发生率,对妊娠合并子宫肌瘤的患者应提供个体化的治疗方案,以保证妊娠及分娩的顺利进行。Objective To discuss uterine fibroids effect on pregnancy and neonatal outcomes. Methods From Dec. 2015 to Dec. 2017,382 pregnant women with uterine fibroids admitted to Beijing Aerospace Hospital were included as a study group,and 382 cases of pregnant women without uterine fibroid during the same period were included as a control group.The difference of pregnancy complications,obstetric outcomes,newborn outcomes between the two groups were compared . Results The incidences of threatened abortion,threatened premature delivery,abnormal fetal position,placenta previa and postpartum hemorrhage rate in the study group were higher than those in the control group [12.0%（45/382） vs 2.8 %（11/382）, 6.0%（22/382） vs 1.0%（4/382）, 11.2%（43/382） vs 2.6%（10/382）,14.1%（54/382） vs 3.9 %（15/382）,10.7%（41/382） vs 3.4%（13/382）] （ P 〈0.01）,but there was no significant difference in the incidence of premature rupture of membranes and placental abruption between the two groups（ P 〉0.05）. The cesarean section rate in the study group was significantly higher than that in the control group[66.2%（253/382） vs 33.0%（126/382）] （ P 〈 0.01 ）. The incidences of fetal distress and low birth weight infants in the study group were higher than those in the control group[5.5%（21/382） vs 1.3%（5/382）,11.0%（42/382） vs 2.9%（11/382）]（ P 〈0.01）,but there was no significant difference in the incidence of neonatal asphyxia and fetal malformation between the two groups（ P 〉 0.05 ）. Conclusion Uterine fibroids increase the incidence of complications during different pregnant stages,and adverse maternal and infant outcomes,and we should provide individualized treatment based on the different characteristics of the fibroids to ensure successful pregnancy and delivery.

关 键 词：子宫肌瘤 孕产期并发症 新生儿结局 

分 类 号：R135[医药卫生—劳动卫生]