Clinical Analysis Of 372 Cases Of Pregnancy Complicated With Uterine Myomas

Objective:To analyze the diagnosis of pregnant women with uterine fibroids, indications of cesarean section and the security of caesarean myomectomy. The preliminary analysis of the effect of progesterone on mymoas,fetus, obstetrics complication in the course of pregnancy.Methods:We collect 372 cases of pregnant women with myomas who had delivered single newborns from November 2013 to June 2015 in Shandong Provincial Hospital. In 82 cases of keep the babies of them, There are 32 cases in the treatment group who meeting standards of using intramuscular progesterone 40 mg daily for one month and taking orally Dydrogesterone 20 mg daily for two months in early pregnancy on account of threatened abortion or had a similar history.In the same case, non-medication 27 cases in the control group. An analysis of the effect of progesterone on mymoas,fetus, obstetrics complication in the course of pregnancy. Immunohistochemically SP method were used to observe the two groups (60 cases) progesterone receptor expression in the uterine fibroids organizations.Results:1. Of all the 372 cases,109 cases (27.42%) found fibroids in pre-pregnancy and gestational earlier period,71 cases (19.09%) found in second trimester,21 cases (5.65%) found in last trimester and 171 cases (45.97%) in cesarean delivery process.2.82 cases from the 372 cases prevent miscarriages in the process of pregnancy because of various factors,12 cases prevent in hospital because of the uterus myoma red degeneration, accounting for 14.63%.3.322 cases (86.56%) terminate pregnancies by cesarean section, while 50(13.44%) cases by spontaneous delivery. Ultrasound diagnosis pregnancy women with myomas in the prenatal test is 54.03%(n=201), and 151 cases (75.12%) terminate pregnancies by cesarean section.The main cause of cesarean section is uterine fibroid, accounting for 27.15%(n=41) and the second is the uterine scars (37 cases), and 4 cases of hysteromyomectomy and 33 cases of cesarean section history, accounting for 24.50%.4. Comparing the treatment group(32 cases) and control group(27 cases). we found myomas increased during pregnancy in both(P< 0.01)and there is no significant difference between the two groups (P> 0.05). Meanwhile we found there is no difference in red degeneration rate and Progesterone receptor expression rate in both(P>0.05). At the same time, There’s no obvious difference in the fetal weight, body length,Scores of Apgar of the newborns,bleeding volume and operative time between the two groups (P>0.05)Conclusions:l.The main factors effecting on gestation is the location of uterine fibroids.The infertile women caused by uterine fibroids and those who have obstetric complications such as recurrent miscarriage require treatment individualized.2. The pregnancy with uterine fibroids is not indications of cesarean section.The way to terminate a pregnancy needs comprehensive analysis. But if no taboos, a natural birth is advocated.3.It is feasible to carry out myomectomy during cesarean delivery because of obstetrical factors,and it is no obvious influence on puerperal recovery.4.Pregnant woman complicated with myoma using progesterone if necessary to prevent miscarriages have no affect on fibroids, the fetus and obstetric complications. The mechanism needs to be studied further.