Analysis Of High-intensity Focused Ultrasound On Postoperative Pregnancy And Relevant Factors In Patients With Uterine Fibroids

Objective:To investigate the effect of high-intensity focused ultrasound and transabdominal myomectomy on reproductive outcome in patient who had pregnancy intention with uterine leiomyoma after operation,and the relevant fators of prgnancy.Aiming to provide more perfect treatment strategy for patients with Uterine leiomyoma who still have fertility requirements.Methods:(1)For HIFU,A total of 186 patients with Uterine fibroids were selected randly by HIFU treatment in The first affiliated hospital of kunming medical university from time 2014-01-01 to 2018-12-06.This one was reseach group(HIFU),The myoma of size,number,location and volum were recorded via our vaginal ultrasounds and collecting materials.For TAM,116 cases were including in comparison group(TAM),collecting data as before.Results:(1)For reseach group and comparison group,the follow-up time was 4 years.A total of 302 cases,there were 85 patients successfully pregnant.Pregnancy after treatment in the two groups:69 cases(81.18%)in the study group were higher than the control group in 16 cases(18.82%).Comparing to the pregnancy outcome,42cases live birth(60.09%,including 2 cases IVF)and 27 cases abortion(39.10%,including 1 case ectopic gestation)were effective in the study group and 12 cases live birth(75.00%)and 4 cases abortion in the control group(p>0.05).(2)Delivery mode of two groups:the study group were higher dramatically than control group in the rate of vaginal delivery(study group 32 cases,80.00%VS control group 3 cases,30.00%)(p<0.05).There were no uterine ruptures in the two groups,other related obstetric complications:In the reserch group,2 patient bleeding during labor,1 case birth canal obstruction.,but in the control group,there were no any relectant complications.All in all,study group had a lower incidence rate of adverse outcomes.(3)Compare to the observational index:age,BMI,the amount,size,locations,volu-m of uterine fibroids and treatment,univariate analysis indicated that age,treatment and BM,were the relevant factors influencing pregnancy after treatment of uterine fibroids,and the independent factors affecting pregnancy after extrinsic crossover were treatment and age(p<0.05);The different treatments played a role in pregnancy,adopting HIFU to ablate the uterine fibroids,its relevant pregnancy was superior to TAM(P<0.001).The age of patients was under 35 years old to be pregnant(p=0.001),HIFU was 33.63±4.75 years old.Conclusion:(1)Different treatments of had paid an attention to patients with uterine fibroids in the reproductive need.In this reseach,HIFU treatment has a higher rate of pregnancy than TAM.It revealed that the treatment of HIFU had a remarkably lower rate of CSP,and the incidence rate of vaginal delivery was increased,which optimizing the pregnancy outcome.(2)In conclution,HIFU was adapt to 33.63±4.75 years old patients,which had the average diameter 5.28±1.68 cm,major in singe,back wall and intramural myoma(p<0.05).Its preganancy interval time ranged 3 months to 12 months.However,the diameter from 5 cm to 8 cm of myoma there was no difference in HIFU or TAM.(2)Concludly,HIFU showed that it had a significant application value,which birth control for a short time,about 3 months to 6 months,It is one of the optimal treatment adopted to patients with uterine fibroids in the reproductive need.