202例子宫肌瘤在妊娠期间生长模式的回顾性分析  

A retrospective analysis of growth pattern of uterine leiomyoma in 202 pregnant women

作　　者：林晓龙 李明 姜桦 LIN Xiao-long;Li Ming;JIANG Hua(Gynecology,Obstetrics&Gynecology Hospital of Fudan University,Shanghai 200001)

机构地区：[1]复旦大学附属妇产科医院妇科,上海200001

出　　处：《生殖医学杂志》2023年第6期813-817,共5页Journal of Reproductive Medicine

摘　　要：目的探讨子宫肌瘤在妊娠期间的生长模式。方法回顾性分析2019年1月至2022年9月在复旦大学附属妇产科医院产检并分娩的202例妊娠合并子宫肌瘤患者的临床资料,分别在早孕期、中孕期、晚孕期测量子宫肌瘤3条径线,比较不同妊娠阶段子宫肌瘤的体积变化,分析与肌瘤体积变化相关的影响因素;同时统计不良妊娠事件的发生情况并分析与其相关的危险因素。结果与早孕期相比,子宫肌瘤体积在中孕期增加(172.54±281.95)%,在晚孕期增加(117.56±245.92)%。与中孕期相比,子宫肌瘤体积在晚孕期减少(9.84±62.66)%。肌瘤体积变化与年龄、孕前体质量指数(BMI)、孕次、产次、早孕期肌瘤最大径线、肌瘤数量无显著相关(P>0.05)。不良妊娠事件包括28例(13.86%)子宫肌瘤红色变性、3例(1.49%)产后出血和4例(1.98%)早产。年龄、孕前BMI、早孕期肌瘤最大径线、肌瘤数量对肌瘤红色变性的发生均无显著影响(P>0.05)。结论子宫肌瘤在妊娠期间呈体积先增后减的生长模式,中孕期显著增长,晚孕期缩小,但终体积仍大于早孕期。Objective:To explore the growth pattern of uterine leiomyoma during pregnancy.Methods:The clinical data of 202 pregnant women with uterine leiomyoma who received regular antenatal examinations and delivered in Obstetrics&Gynecology Hospital of Fudan University from January 2019 to September 2022 were retrospectively analyzed.Three diameter lines of uterine leiomyoma were measured during the 1 st,2 nd and 3 rd trimester of pregnancy,respectively.The leiomyoma volume was compared between different trimesters of pregnancy,and the influencing factors related to changes in leiomyoma volume were analyzed.Simultaneously the occurrence of adverse pregnancy events and their associated risk factors were evaluated.Results:Compared with the 1 st trimester pregnancy,the volume of uterine leiomyomas increased by(172.54±281.95)%in the 2 nd trimester of pregnancy and(117.56±245.92)%in the 3 rd trimester of pregnancy.Compared with the 2 nd trimester of pregnancy,the volume of uterine leiomyomas decreased by(9.84±62.66)%in in the 3 rd trimester of pregnancy.There was no significant correlation between changes in leiomyoma volume and age,pre-pregnancy body mass index(BMI),gravidity,parity,maximum diameter line of leiomyoma in the 1 st trimester of pregnancy,and number of leiomyomas.Adverse pregnancy events included 28 cases(13.86%)of red degeneration of uterine leiomyomas,3 cases(1.49%)of postpartum hemorrhage,and 4 cases(1.98%)of premature delivery.Age,pre-pregnancy BMI,maximum diameter of leiomyoma in the 1 st trimester of pregnancy,and the number of leiomyomas had no significant impact on the occurrence of red degeneration of leiomyoma(P>0.05).Conclusions:Uterine leiomyomas exhibit a growth pattern of first increasing and then decreasing in volume during pregnancy.Uterine leiomyomas tend to grow substantially during the 2 nd trimester of pregnancy,but shrink remarkably during the 3 rd trimester of pregnancy and the final volume of myomas is still higher than that in the 1st trimester.

关 键 词：子宫肌瘤 妊娠 生长模式 肌瘤变性 

分 类 号：R711.74[医药卫生—妇产科学]