Clinical characteristics and perinatal outcomes of pregnant women complicated with giant uterine leiomyoma
LIU Na, WANG Shuo
1.Department of Gynecology & Obstetrics, Beijing Friendship Hospital Affiliate to Capital Medical University, Beijing 100051, China; 2.Department of Gynecology & Obstetrics, Pinggu Campus, Beijing Friendship Hospital Affiliate to Capital Medical University, Beijing 101211, China
Abstract: 【Abstract】 Objective To investigate the maternal and fetal outcomes of pregnant women with giant uterine leiomyoma and the growth situation of leiomyoma. Methods From January 2016 to December 2018, there were 8 268 pregnant women who deliveried in Beijing Friendship Hospital. Among of them 20 cases with giant fibroids served as giant fibroids group, and 221 cases with leiomyoma less than 9 cm served as control group. According to the ultrasonic results before delivery or the findings during cesarean, the leiomyoma with diameter ≥ 9 cm or weight ≥ 800 g was defined as giant uterine leiomyoma. These patients were examined by ultrasound regularly, and the newborns were followed up after delivery. t test and χ2 test were used for statistical analysis. Results The prevalence of uterine leiomyoma during pregnancy was 2.9% (241/8 268) from January 2016 to December 2018. The prevalence of giant leiomyoma was 2.4‰ (20/8 268). There was no significant difference in the age,the gravidity and parity between the giant leiomyoma group and the control group (P>0.05). 18 patients of giant leiomyoma group were registered in our hospital for regular examination. The mean size of leiomyoma in early pregnancy was (9.0±1.9) cm, (11.5±2.6) cm in middle pregnancy, and (13.1±3.1) cm in late pregnancy. The incidence of myomatous pain syndrome in giant leiomyoma group and control group was 15.0% (3/20) vs 6.3% (14/221), with no significant difference. In giant leiomyoma group, one case was terminated for hypertensive disorders complicating pregnancy at 29 weeks, and one case suffered intrauterine fetal death at 32 weeks. Remaining 18 cases were delivered at 36-40+6 weeks of gestation. The average birth weight of the newborn in giant leiomyoma group and control group were (3 169±716) g vs (3 392±452) g, with no significant difference (P>0.05). There was no significant difference in the volume of vaginal bleeding during vaginal delivery between giant leiomyoma group and control group ［(306±129) ml vs (325±168) ml］. The amount of bleeding during cesarean section in
giant leiomyoma group was (608±269) ml, higher than that in control group ［(166±126) ml］(P<0.05).Conclusions The volume of uterine leiomyoma is likely to increase during pregnancy. The giant uterine myoma doesn't increase the risk of myomatous pain syndrome. The delivery mode should be assessed by comprehensive situation about leiomyoma, mother and fetus. Patients with giant leiomyoma have the opportunity of natural delivery.
刘娜 王硕. 妊娠合并巨大子宫肌瘤的临床特点及围产结局[J]. 发育医学电子杂志, 2020, 8(1): 42-46.
LIU Na, WANG Shuo. Clinical characteristics and perinatal outcomes of pregnant women complicated with giant uterine leiomyoma. Journal of Developmental Medicine(Electronic Version), 2020, 8(1): 42-46.
2020, Vol. 8 
