卵巢肿瘤对妊娠结局的影响

目的探讨妊娠合并卵巢肿瘤的特征、诊断和治疗对妊娠结局的影响。方法回顾性分析144例妊娠合并卵巢肿瘤的临床、病理及随访资料。结果患者年龄20~41岁,平均28.28岁。择期或剖宫产同时切除卵巢肿瘤103例,因并发症急诊手术41例。良性肿瘤136例,恶性肿瘤8例(5.55%),病理类型以囊性成熟性畸胎瘤为主共74例(51.39%)。足月妊娠91例(63.19%),人工流产37例,自然流产14例,早产2例,胎儿宫内窘迫及新生儿窒息共18例。2例卵巢恶性肿瘤因延期化疗,术后短期内复发。结论妊娠合并卵巢肿瘤影响患者的生育意愿,早孕期人工终止妊娠率高。卵巢肿瘤蒂扭转是急诊手术的主要原因,导致良性肿瘤单侧附件切除率高,术后易引起流产。孕14~22w或剖宫产同时切除卵巢肿瘤对妊娠结局无明显不利影响,恶性肿瘤应按非孕期原则治疗。

Effect of ovarian tumors on outcome of pregnancies

Objective:To explore the clinical features,diagnosis,treatment and progriosis of the pregnancy with ovarian tumor,to explore effect of ovarian tumors on outcome of pregnancies.Methods: A retrospective analysis was done 144 cases of the pregnancy with ovarian tumor treated in Chinese PLA General Hospital from 1980 to 2002.Results: 144 cases aged from 20-41 years.All cases received operation.41 cases were given urgent operation because of the twisting of pedicle of ovarian tumors and other complications.Of them,136 were benign and cystic teratoma was the most requently(74 cases,51.39%)seen and 8 malignant.6 of the malignant cases are in stage I and 2 cases ovarian malignant tumor was recurrence after opration by the followup.The mature delivery was 63.19%(91/144),artificial abortion 37 cases,spontaneous abortion 14 cases and premature delivery 2 cases and neonatal asphyxia 18 cases.Conclusion: Effect of ovarian tumors on outcome of pregnancies was disadvantage.Artificial abortion rate and the twisting of pedicle of ovarian tumors were high.The cases of pregnancy with benign ovarian tumor should be monitored periodically,and given operations at selected time.The best time for operation is between 14 to 22 weeks after pregnancy,but the malignant cases should have operation in time.