Influence of assisted reproductive technology and uterine leiomyoma on pregnancy outcomes in women with adenomyosis

Q4 Medicine Gynecology and Obstetrics Clinical Medicine Pub Date : 2023-03-01 DOI:10.1016/j.gocm.2023.01.008

Yi-Ling Wang , Zhao Tian , Xiao-Hong Chang, Hong-Lan Zhu, Heng Cui

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Abstract

Aim

To assess whether adverse pregnancy outcomes in women with adenomyosis are different according to the method of conception and the concurrent of uterine leiomyoma (UL).

Methods

We performed a retrospective study. Fifty-three singleton pregnancy cases complicated with adenomyosis were included in this study. In the study group, 15 women became pregnant with assisted reproductive technology (ART) and 21 women combined with UL. Pregnancy outcomes were compared between ART and non-ART, UL and non-UL groups.

Results

The prevalence for such complications as hypertensive disorder complicating pregnancy (HDCP)and postpartum hemorrhage (PPH)were significantly higher in the women conceived by ART (33.3% vs. 5.3%, P = 0.023) and (53.3% vs. 23.7%, P = 0.037),respectively. And women concurrent with UL of which the diameter≥4 cm were more likely to have severe PPH (44.4% vs. 0%, P = 0.021).

Conclusion

ART may increase the risk of adverse pregnancy outcomes such as HDCP and PPH in women with adenomyosis and UL of which the diameter≥4 cm may further increase the risk of severe PPH.

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辅助生殖技术和子宫平滑肌瘤对妊娠结局的影响

目的探讨子宫腺肌病患者的不良妊娠结局是否因受孕方式及并发子宫平滑肌瘤(UL)的不同而不同。方法采用回顾性研究。本研究纳入53例单胎妊娠合并子宫腺肌病的病例。在研究组中，15名妇女通过辅助生殖技术(ART)怀孕，21名妇女联合使用UL。比较ART组和非ART组、UL组和非UL组的妊娠结局。结果ART妊娠组妊娠期高血压疾病(HDCP)和产后出血(PPH)发生率分别为33.3%比5.3% (P = 0.023)和53.3%比23.7% (P = 0.037)。合并UL且直径≥4 cm的女性发生严重PPH的可能性更大(44.4%比0%，P = 0.021)。结论art可增加子宫腺肌症和子宫内膜直径≥4 cm的子宫内膜炎患者发生HDCP和PPH等不良妊娠结局的风险，进一步增加重度PPH的发生风险。

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