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目的:回顾性分析有生育要求子宫腺肌病患者的妊娠结局。方法:选取2015年6月至2020年5月在青岛大学附属妇女儿童医院就诊的有生育要求、超声诊断为妊娠合并子宫腺肌病且临床资料完整的患者231例。根据妊娠前子宫腺肌病的治疗方式分为：期待组78例、药物组111例和手术组42例，分析3组患者治疗前的一般资料，并总结妊娠结局。再根据早孕期是否予药物保胎治疗，将自然受孕的无先兆流产症状的患者分为观察组和保胎组，比较两组患者的早孕期妊娠结局。结果:（1）与期待组相比，药物组和手术组患者的年龄较大，分别为（31.5±1.8）、（34.1±3.7）、（36.9±3.6）岁（n P<0.05）。期待组有临床症状的患者比例低，仅占11.5%（9/78），而药物组和手术组患者发生痛经、经量增多的比例较高。药物组和手术组患者的子宫体积大于期待组，分别为（151±46）、（166±27）、（97±18）cmn 3（n P<0.05）。手术组患者78.6%（33/42）为局灶型病灶。期待组患者自然受孕的比例为97.4%（76/78），药物组和手术组患者以辅助生殖治疗为主。（2）期待组、药物组、手术组患者的流产率分别为48.7%（38/78）、46.8%（52/111）、59.5%（25/42）。与药物组和手术组相比，期待组患者的早产率低，分别为55.9%（33/111）、11/17、12.5%（5/78），自然分娩率高，分别为44.1%（26/111）、4/17、67.5%（27/78）。（3）自然受孕无先兆流产症状的患者共89例，其中观察组31例、保胎组58例；与观察组相比，保胎组患者流产率低［41.9%（13/31）、34.5%（20/58）］，两组比较，差异有统计学意义（n P<0.05）。n 结论:有生育要求的子宫腺肌病患者应综合评估，予以个体化治疗方案。妊娠合并子宫腺肌病患者流产率高，应纳入高危孕产妇管理。早孕期积极进行保胎治疗，在一定程度上可改善妊娠结局。“,”Objective:To retrospectively analyze the pregnancy outcomes of patients with adenomyosis requiring fertility in a single center under real world condition.Methods:From June 2015 to May 2020, 231 cases of pregnancy complicated with adenomyosis diagnosed by ultrasound with fertility requirements were treated in the Women′s and Children′s Hospital Affiliated to Qingdao University with complete clinical data. And they were divided into three groups according to the treatment of adenomyosis before pregnancy: expectation group, drug group and operation group. The relevant data before pregnancy of the three groups were analyzed, and the pregnancy outcomes of the patients were summarized. According to whether the early pregnancy was treated with medication, the patients who were naturally conceived without symptoms of threatened abortion were divided into observation group and fetus protection group, and the pregnancy outcomes of the two groups were compared.Results:(1) Compared with the expectation group, the ages of patients in the drug group and the operation group were larger [(31.5±1.8) vs (34.1±3.7) vs (36.9±3.6) years old], and the difference was statistically significant (n P<0.05). Only 9 patients (11.5%, 9/78) had clinical symptoms in the expectation group, while the patients in the drug group and the operation group had a higher proportion of dysmenorrhea and increased menstrual volume. The uterine volume of the drug group and the operation group were larger than that of the expectation group [(151±46) vs (166±27) vs (97±18) cmn 3], the difference was statistically significant (n P<0.05). 78.6% (33/42) of the operation group were focal adenomyosis. The proportion of natural pregnancy in the expectation group was 97.4% (76/78), and in vitro fertilization and embryo transfer was mainly used in the drug group and the operation group. (2) The abortion rates of the three groups were 48.7% (26/111), 4/17, 67.5% (27/78) respectively. Compared with the drug group and the operation group, the preterm birth rate was lower [55.9% (33/111) vs 11/17 vs 12.5% (5/78)] and the natural delivery rate was higher [44.1% (26/111) vs 4/17 vs 67.5% (27/78)] in the expectation group. (3) There were 89 cases of spontaneous pregnancy without threatened abortion symptoms, including 31 cases in the observation group and 58 cases in the fetus protection group. Compared with the observation group, the abortion rate of patients in the fetus protection group was lower [41.9% (13/31) vs 34.5% (20/58)], and the difference was statistically significant (n P<0.05).n Conclusions:Patients with adenomyosis who have fertility requirements should be comprehensively evaluated and individualized treatment plans should be given. Pregnancy patients with adenomyosis have a high rate of miscarriage, and they should be included in the management of high-risk pregnant women. Active fetal protection treatment during early pregnancy might improve pregnancy outcomes.