Treatment Of Pregnancy Associated With Hysteromyoma During Perinatal Period

Introduction:Pregnancy with leiomyomas is a common disease encountered by the gynecologist. Leiomyomas have been observed more frequently in pregnancy because many women are delaying childbearing, prenatal examination payed attention to and progress of diagnostic imaging technologies..The incidence of pregnancy with leioomyomas gradually increased. Treatment s of myoma in pregnancy are a challenge for obstetrician and gynecologists.Objective:To investigate the best management of myomas in pregnancy and to find out a strategy for it by analyzing the interaction of pregnancy and leiomyoma,pregnancy outcomes.Methods:Retrospective analyzing therapeutic effects of 56 cases of pregnant women with uterine leiomyomas in different gestation period..Results:56 cases of pregnant women with uterine fibroids were investigated, except for 1 case inevitable abortion and 3 cases of premature delivery, all cases remained pregnancy to term, including 9 cases of vaginal delivery,27 cases of cesarean section (including hospitalized cases from first or second trimester to term), besides,16 cases were diagnosed during cesarean section. In conclusion, the cesarean rate is 82.7%, the vaginal delivery rate is 17.3%, the spontaneous abortion rate is 2.1% and the premature delivery rate is 4.3%. Cases with myoma diameter≥8cm had longer operation time, more intraoperative hemorrhage, more prostpartum bleeding and higher postpartum infection rate. No significant difference was found in postoperative fever rate between pregnant women with myomas diameter<8cm and>8cm.Conclusions Myomectomy during cesarean section (CS) can be performed in selected cases,like as subserous myoma, single intramural myoma (myoma diameter<8cm) and multiple intramural myoma (myoma diameter 1-3m).for cases of interstitial myoma, intraligamentary myoma and lower uterine myoma.If the myomas located in lower uterine segment and intraligamentary, it would be better to avoid myomectomies during CS because of the high risk of uterine atony and severe hemorrhage, which can lead to hysterectomy and subsequent impairmentof fertility.