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| Influence of different surgical methods for treating advanced women with adenomyosis on their pregnancy outcomes after surgery |
| The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, 075000 |
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Abstract To explore the influence of different surgical methods for treating advanced women with adenomyosis on their pregnancy outcomes after surgery. Methods: The clinical data of 116 advanced women with adenomyosis who had undergone adenomyosis focal resection and had fertility requirements from December 1, 2011 to December 1, 2016 were analyzed retrospectively. Among them, 52 women with transabdominal adenomyoma focal resection were in group A, and 64 women with laparoscopic adenomyoma focal resection were in group B. In addition, 78 pregnant women with adenomyosis who had hospitalized and delivered during the same period were selected in group C. The pregnant situation of the women was compared among the three groups, and the influencing factors were analyzed. Results: Among 116 women with adenomyosis who had undergone adenomyosis focal resection, 65 (56.0%) women were pregnancy within 2 years after surgery. There were no significant differences in the rates of pregnancy and recurrence of adenomyosis of the women in 6 months, 1 year, and 2 years after surgery between group A and group B (P＞0.05). The rates of age ≥40 years old, no recurrence of adenomyosis, no residual lesion, and assisted reproductive technology used of the women with postoperative pregnancy in group A and B were significant higher than those of the women without postoperative pregnancy (P＜0.05). Multivariate logistic regression analysis showed that age ≥40 years old, and no assisted reproduction used after surgery of the women were the risk factors of their postoperative pregnancy (OR=3.580, 4.927, P＜0.05). The no postoperative recurrence of adenomyosis and no postoperative residual lesion of the women were the protective factors of their postoperative pregnancy (OR=0.220, 0.173, P＜0.05). The incidences of preterm birth (9.2%), abortion (13.9%), low birth weight (10.7%), placenta previa (6.2%), delivery infection (7.7%), and pelvic adhesions (10.8%) of the women in group A and group B were significantly higher than those (1.3%, 2.5%, 2.6%, 0, 0, and 1.3%) of the women in the control group (all P＜0.05). Conclusion: Advanced age, postoperative recurrence of adenomyosis, residual lesions of adenomyosis, and no assisted reproductive technology used after surgery of the women with adenomyosis can affect their postoperative pregnancy, and these women after pregnancy have higher incidence of pregnancy adverse outcomes. Therefore, the advanced women with adenomyosis who have fertility requirements maybe try to pregnancy with the disease of adenomyosis.
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