经手术确诊子宫内膜异位症患者自然妊娠结局的回顾性分析

Retrospective Analysis of Natural Pregnancy Outcomes in Patients With Surgically Diagnosed Endometriosis

目的 探讨经手术确诊的子宫内膜异位症患者与同期分娩的非子宫内膜异位症患者的自然妊娠结局,了解子宫内膜异位症对妊娠结局的影响。方法 回顾性分析2014年1月—2018年12月在福建中医药大学附属福鼎医院经手术确诊的子宫内膜异位症患者261例,随访至2019年12月,发生自然妊娠并在福建中医药大学附属福鼎医院产检及分娩的患者共53例。并收集同期在福建中医药大学附属福鼎医院分娩的非子宫内膜异位症患者497例。比较二者在年龄、体质量指数、既往是否发生不孕及孕期发生先兆流产、先兆早产、未足月胎膜早破、胎膜早破、妊娠期高血压疾病、妊娠期糖尿病、前置胎盘、胎盘早剥、分娩方式、产后出血、新生儿情况的差异。结果 非内异症组体质量指数高于内异症组,差异有统计学意义(P=0.000);内异症组的既往不孕发生率、妊娠期阴道流血、先兆流产、先兆早产、前置胎盘、剖宫产发生率均高于非内异症组,差异有统计学意义(P <0.05);在发生胎膜早破、妊娠期高血压疾病、妊娠期糖尿病、胎盘早剥、产后出血则两组间差异无统计学意义(P> 0.05);两组新生儿体质量、新生儿窒息发生率差异无统计学意义(P> 0.05)。结论 子宫内膜异位症患者发生不良妊娠结局和剖宫产的风险增加,建议临床医生加强对此类患者妊娠期及分娩期的管理。

Objective To investigate the natural pregnancy outcome between patients with surgically confirmed endometriosis and patients without endometriosis who delivered at the same time, and to understand the influence of endometriosis on pregnancy outcome.Methods A retrospective analysis was performed on 261 cases of patients with endometriosis diagnosed by surgery in Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2014 to December 2018, and followed up to December 2019. A total of 53 patients with natural pregnancy and delivery in Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine were included. A total of 497 patients with non-endometriosis who delivered in Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine during the same period were collected.The differences in age, body mass index, previous infertility,threatened abortion, threatened premature delivery, premature rupture of membranes, premature rupture of membranes, gestational hypertension, gestational diabetes, placenta previa, placental abruption,delivery mode, postpartum hemorrhage and neonatal conditions were compared between the two groups. Results Body mass index of nonendometriosis group was higher than that of endometriosis group,the difference was statistically significant(P =0.000). The incidence of previous infertility, vaginal bleeding during pregnancy, threatened abortion, threatened premature delivery, placenta previa and cesarean section in the endometriosis group were higher than those in the nonendometriosis group, with statistical significance(P < 0.05). There were no statistically significant differences in the occurrence of premature rupture of membranes, gestational hypertension, gestational diabetes,placental abruption and postpartum hemorrhage between the two groups(P > 0.05). There were no statistically significant differences in neonatal weight and incidence of neonatal asphyxia between the two groups(P > 0.05). Conclusion Patients with endometriosis have an increased risk of adverse pregnancy outcomes and cesarean section, and clinicians are advised to strengthen the management of these patients during pregnancy and delivery.