高强度聚焦超声消融治疗子宫肌瘤时妊娠一例报告并文献复习

高强度聚焦超声(high-intensity focused ultrasound,HIFU)消融治疗子宫肌瘤作为一种新的非侵入性的治疗方式,已越来越广泛地用于子宫肌瘤的治疗。但是对于HIFU治疗时妊娠的处理及妊娠结局鲜有文献报道。本文报道1例HIFU消融治疗子宫肌瘤时妊娠的病例,结合文献复习,探讨子宫平滑肌瘤对妊娠的影响、子宫平滑肌瘤不同处理方式对妊娠的影响、HIFU消融治疗子宫肌瘤时机选择的问题、HIFU消融治疗子宫肌瘤若同时合并妊娠时胎儿去留的问题以及近期HIFU消融治疗子宫肌瘤后对流产手术操作的影响等,以期对HIFU治疗子宫肌瘤的适应证、选择合适的治疗时间及术后选择合适的妊娠时机展开讨论。

High-Intensity Focused Ultrasound Ablation for Uterine Leiomyoma in A Pregnant Woman:A Case Report and Literature Review

High-intensity focused ultrasound(HIFU)ablation for uterine leiomyoma,as a new non-invasive treatment,has been more and more widely used in the treatment of uterine leiomyoma.However,there are few literature reports on the early pregnancy and pregnancy outcome after the improper timing of HIFU treatment for uterine leiomyoma.We report a case of inappropriate timing of high-intensity focused ultrasound ablation for uterine leiomyoma in a pregnant woman,with literature review.We summarize the influence of uterine leiomyoma on pregnancy,the influence of different treatment methods on pregnancy,the timing of HIFU ablation for uterine leiomyoma,the problem of fetal retention when HIFU ablation for uterine leiomyoma combined with pregnancy,and the effect of HIFU ablation for uterine leiomyoma on abortion operation,etc.Even more important,we discuss the indication of HIFU ablation for uterine leiomyoma,the appropriate treatment time,and the appropriate pregnancy opportunity after HIFU operation.