妊娠15-16周巨型子宫肌瘤切除成功，原发性不孕症延长

乳腺病理、癌症、妇科、产科病理、姑息护理、老年学联合会议

2019年6月28日至29日|挪威奥斯陆

娜塔莉亚·贝尔金娜，瑞佐娃N K，罗丹N V和帕西娜O B

GBUZ NO“捷尔任斯基围产期中心”，俄罗斯NUZ“铁路临床医院”，俄罗斯

海报和接受的摘要:RRJMHS

摘要

子宫肌瘤是女性生殖系统中最常见的良性肿瘤。根据不同作者的说法，子宫肌瘤疾病的发病率从15%到50%不等。在15-17%的女性中，子宫肌瘤发生在30岁及以上。发现子宫肌瘤的平均年龄为32岁。尽管积极安排医学检查，但仍有子宫肌瘤较大，有时体积巨大并伴有妊娠的患者。此外，已知的是，在怀孕时，肌瘤的节点可以生长，达到巨大的尺寸，并导致邻近重要器官的破坏。通常，存在大子宫肌瘤时，妊娠的发展是非常有问题的，并以终止妊娠结束。根据以V.I. Kulakov院士命名的FGU NCAAAP的数据，60.9-95.5%的子宫肌瘤妇科手术干预都是根治性的。然而，我们诊所的经验表明，不仅可以保存子宫，还可以进一步妊娠足月妊娠和后续分娩。患者l的故事就是这样一个例子。32岁的患者患有原发性不孕症，以生殖道出血、虚弱、头晕为主诉，紧急进入妇科。 She presented some uterine fibroids of gigantic size and severe iron deficiency anemia (HB-39g/L). According to the uterus USI results, a pregnancy of five to six weeks was diagnosed against the background of interstitial uterine fibroids of 13-14cm in size. Given the long-term infertility, the patient refused to terminate the pregnancy, conducted antianemic and preserving therapy. At 15-16 weeks, the patient’s condition worsened; there were complaints about dysfunction of adjacent organs, frequent urination, pain in the iliac areas, the impossibility of a long stay in an upright position. According to the ultrasound study, the growth of the myoma node is up to 20cm. An emergency treatment was performed: A laparotomy myomectomy of a giant interstitial myoma (myoma weight-2kg) during pregnancy 15-16 weeks without opening the cavity with preservation of the fetus, using blood-saving technologies. At 37-38 weeks, planned delivery was by cesarean section. A live, full-term girl was taken out (weight-2800gr, height-48cm). Thus, patients with uterine myoma should be thoroughly carried out with pregravid preparation and, if necessary, undergo indications myomectomy at the planning stage of pregnancy. During pregnancy, myomectomy should be performed by a highly skilled surgical team with the obligatory observance of surgical rules and the use of modern blood-saving technologies.

传记

娜塔莉亚·贝尔金娜，1978年出生，毕业于下诺夫哥罗德医学院俄罗斯联邦联邦边防部队军事医学研究所。

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