腹腔鏡下子宮筋腫核出術と開腹子宮筋腫核出術とが及ぼす周産期予後の検討

抄録

Objective: Myomectomy is the most popular treatment for women who wish to become pregnant in the future. Laparoscopic myomectomy (LM) has been increasingly performed and will probably continue to increase in popularity in the future. This study aimed to compare the perinatal outcomes after LM versus abdominal myomectomy (AM).

Methods: We studied women who had myomectomy before and without recurrence of myoma in the current pregnancy. We included 2387 deliveries performed in the Department of Obstetrics and Gynecology of Fukuoka University Hospital, Fukuoka, Japan from 2013 to 2017.

Results: Fifty-four women delivered after myomectomy. Thirteen women who had undergone LM and 15 who had undergone AM were compared after multiple pregnancies. Pregnancy with the complication of new myoma was excluded. Treatment with ritodrine for preterm labor was required more frequently in LM than in AM. However, there were no significant differences in perinatal outcomes including the rate of preterm delivery, a low Apgar score, and blood loss between patients who had LM and those who had AM. There was no uterine rupture or intrauterine fetal death.

Conclusion: LM requires treatment for preterm labor, but there is no difference in the rate of preterm delivery between LM and AM. There is also no significant difference in perinatal outcome between LM and AM, although careful consultation and follow-up are required.