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目的评估子宫肌瘤的大小对双胎妊娠产科结局的影响。方法选取在首都医科大学附属北京妇产医院建档并于2013年6月至2014年12月分娩的双胎妊娠合并子宫肌瘤患者为研究对象,记录肌瘤基本特征、产妇基本人口统计学特征、不良产科并发症及新生儿结局。结果共有51例患者纳入研究,其中34例肌瘤<5 cm,17例至少有1个肌瘤≥5 cm。≥5 cm肌瘤者与<5 cm肌瘤者相比,其基本人口统计学特征、肌瘤基本特征、不良产科并发症及新生儿结局差异均无统计学意义(P>0.05)。≥5 cm肌瘤较<5 cm肌瘤的变性率(58.82%vs 11.76%,P=0.001)明显增加。在孕中期,<5 cm的肌瘤[(2.87±0.94)vs(3.45±1.22),P=0.018]明显增大。结论子宫肌瘤的大小对双胎妊娠产科结局的影响并不明显。在孕期,≥5 cm的肌瘤更易发生变性。<5 cm的肌瘤在孕中期明显增大。
Objective To evaluate the effect of the size of uterine fibroids on the obstetric outcome of twin pregnancies. Methods Patients with twin pregnancy and uterine fibroids who were filing at Beijing Maternity Hospital affiliated to Capital Medical University and delivered from June 2013 to December 2014 were enrolled in this study. The basic characteristics of fibroids, maternal basic demographic characteristics , Obstetric complications and neonatal outcomes. Results A total of 51 patients were included in the study, 34 of them fibroids <5 cm and 17 of 17 patients with at least 1 fibroids ≥ 5 cm. There was no statistical difference in the basic demographic characteristics, the basic characteristics of myoma, the obstetric complications and the neonatal outcome between ≥5 cm fibroids and those ≤5 cm fibroids (P> 0.05). The degeneration rate of fibroids ≥5 cm was significantly higher than that of <5 cm fibroids (58.82% vs11.76%, P = 0.001). In the second trimester, fibroids <5 cm [(2.87 ± 0.94) vs (3.45 ± 1.22), P = 0.018] increased significantly. Conclusion The size of uterine fibroids has no obvious effect on the obstetric outcome of twin pregnancy. In pregnancy, fibroids ≥ 5 cm are more susceptible to degeneration. Less than 5 cm fibroids in the second trimester significantly increased.