Analysis On Pregnancy Of108Unbearing Women After Myomectomy

Objective:To evaluate pregnancy of unbearing women after myomectomy and its influencing factors.Methods:From January2002to December2010, there are108unbearing women in obstetrics and gynecology department of the second clinical medical school of shanxi medical university,those at the age of18to45years old with uterine myoma and receive myomectomy. and the excluded under hysteroscopy myomectomy patients. Their postoperative pathological results confirm for uterine leiomyoma. By telephone follow-up and inspection of medical records on age, chief complaint in patients with surgical, obstetrical history, menstrual history, preoperative gynecological ultrasound examination results, surgical approach, intraoperative findings, surgical duration, blood loss, postoperative pregnancyand pregnancy outcomes and other indicators of records, sorting, and statistical analysis.Results:In108unbearing women with uterine myoma after myomectomy, underwent open myomectomy24cases, laparoscopic myomectomy84cases,postoperative successful pregnancy in79cases, total pregnant rate is73.15%, among which71cases of childbirth, ongoing pregnancies in7cases, spontaneous abortion in1. The conception in42cases, accounting for53.16%of the total number conception; Two years after conception32cases, accounting for40.51%of the total number conception; Three years after conception4cases, accounting for5.06%of the total number conception; Three years after the conception in1,1.27%of the total number of conception. In71patients who have childbirth,66cases of delivery term pregnancy, premature birth5cases).67patients by cesarean section was pregnancy end, four patients through the vaginal delivery pregnancy end, no case was happened uterine rupture. In108patients with17patients had lost before pregnancy, spontaneous abortion rate was15.7%, the only one case occurred in the early stages of pregnancy produces natural abortion, spontaneous abortion rate was0.9%. Through the single factor analysis, the conclusion patients age at the time of surgery, presence of infertility history, pelvic adhesion degree and get rid of fibroids number was to patients with uterine fibroids eliminate the influence of postoperative pregnancy are statistically significant difference; And operation method, uterine fibroids type, position, size, intraoperative is entering the postoperative uterine pregnancies to patients have no effect. Through the many factors logistic analysis, age at the time of surgery patients, with pelvic adhesion and intraoperative eliminate the number of fibroids P value were less than0.05, namely the uterine fibroids patients who underwent the influence of pregnancy are statistically significant differences, and its all risk factors for postoperative infertility, the older you get, the more serious the combination pelvic adhesion, intraoperative fibroids eliminate number, the more patients who underwent the possibility of pregnancy and smaller.Conclusion:The older the unbearing patient is, the bigger the postoperative appear the likelihood of infertility. The more uterine myoma is removed in myomectomy, the smaller the possibility of pregnancy is. The severe of pelvic adhesions is, the smaller the possibility of pregnancy after myomectomy is. The myomectomy can improve those who has Preoperative history of infertility.Myomectomy can reduce postoperative spontaneous abortion rate. Uterine fibroids, the type of location, size, the operation method, operation duration, peri-operative bleeding, whether through endometrial of postoperative pregnancy rates have no effect.