Analysis Of Pregnancy Outcome After Laparoscopic Myomectomy

Objective:With the opening of the national second-child policy,the number of patients with uterine fibroids with fertility requirements has increased year by year.The purpose of this study was to investigate the factors related to pregnancy outcome after laparoscopic myomectomy.Methods:A retrospective analysis of the case data of patients aged 18 to 45years old who underwent laparoscopic uterine fibroids excision surgery from January 2010 to December 2016 in Ningbo Women and Children's Hospital,by reviewing medical records and telephone calls The general information of the patients,the postoperative pregnancy status of the surgical data and the related data of the delivery were collected.Finally,156 patients were included in the study,and 116 of them were successfully conceived after operation.According to the age group of patients,the patients were divided into?35 years old group and<35 year old group;according to the size of fibroids,they were divided into?5cm group and<5cm group;grouped according to the number of fibroids,single-shot group and multiple-shot group;The relationship between intraoperative fibroids and endometrium is divided into related groups and unrelated groups.The related groups refer to intraoperative fibroid penetration or close to the endometrium,and the type 2 and type 3 fibroids excreted during surgery are classified.Group,the remaining types of fibroids were included in the unrelated group;according to the postoperative pregnancy interval,divided into?12 months group and>12 months group;according to the postoperative delivery mode of delivery during childbirth,divided into vaginal delivery group and cesarean section Production group.Analyze and compare the factors affecting the pregnancy rate after laparoscopic uterine fibroids excision and the long-term pregnancy outcomes(abortion,premature delivery and term).Analyze and compare the factors affecting placental adhesion and postpartum hemorrhage during postoperative pregnancy..At the same time,factors affecting the postoperative cesarean section rate were studied.Results:After comparative analysis,the size of fibroids was correlated with the postoperative pregnancy rate.The larger the fibroids were excavated during surgery,the lower the postoperative pregnancy rate was,and the difference was statistically significant(?~2=6.449,p=0.011).There was a statistically significant difference in pregnancy rates between different age groups(?35 years old group and<35 years old group)(?~2=9.52,p=0.002).There was no correlation between the number and type of fibroids and postoperative pregnancy rate.Multivariate logistic regression analysis of postoperative pregnancy rate suggests that fibroid size is a risk factor for pregnancy or not.Multivariate logistic regression analysis of placental adhesions during postoperative pregnancy suggests that the number of fibroids is postoperative pregnancy.Risk factors for placental adhesions,the greater the number of fibroids,the higher the incidence of placental adhesions,the other factors do not affect the occurrence of placental adhesions.This study found that cesarean section rate during successful gestational delivery of uterine fibroids after laparoscopic surgery Up to 91%,after comparative analysis,the relationship between fibroids and endometrium was correlated with cesarean section rate during postoperative pregnancy(p=0.028),and the other factors were not related to cesarean section rate.Time,size,number of fibroids,type of fibroids,and postoperative patientsThere was no correlation between the incidence of postpartum hemorrhage at the end of pregnancy and delivery.Conclusion:The size of fibroids can affect the pregnancy rate of patients with uterine fibroids after laparoscopic surgery;the number of fibroids can affect the incidence of placental adhesion during pregnancy;The mesothelioma penetrates or closes to the endometrium,and the cesarean section rate increases during postoperative pregnancy delivery.There is no correlation between the intraoperative pregnancy interval and the pregnancy outcome,which can shorten the postoperative contraception time and improve the postoperative pregnancy rate.