The Study Of Relevant Influence Factors On Reproductive Outcomes After High Intensity Focused Ultrasound Ablation For Uterine Fibroids

Background:Uterine fibroids are the most common benign tumors of female reproductive organs,with an incidence ranging from 5.4%to 77%.Clinical intervention is often required because of abnormal menstruation,recurrent abortion,infertility and other symptoms.High intensity Focused Ultrasound(HIFU),as a non-invasive approach for treating uterine fibroids,has advantages of less trauma,fast recovery,without hospitalization while retaining the patient's reproductive function.Existing studies have shown that HIFU is safe and effective in the treatment of uterine fibroids,and has no obvious effect on ovarian function.However,At present,there are few reports on the pregnancy status of patients with uterine fibroids requiring fertility after HIFU treatment and the influencing factors of pregnancy in patients with HIFU treatment.Objectives:1.To investigate the pregnancy status of patients with uterine fibroids with fertility requirements after HIFU treatment;2.To investigate the influencing factors of pregnancy in patients with uterine fibroids with fertility requirements after HIFU treatment.Materials and methods:1.The data of patients with uterine fibroids with fertility requirements before HIFU treatment and values of intraoperative parameters were collected,and pregnancy status,pregnancy outcome,neonatal status,fibroid ablation rate and volume reduction rate after treatment were followed up.2.Patients depending on the pregnancy outcome,can be divided into pregnancy and pregnancy group,compared two groups of patients in the preoperative age,birth history,history of infertility,spontaneous abortion history,the types of fibroids,fibroids maximum diameter,number of myoma and Symptom Severity Scale(SSS),Uterine Fibroid Symptom and Quality of Life(UFS·QOL),intraoperative dosage parameter values,postoperative fibroids ablation rate and volume shrinking rate of different factors,it is concluded that HIFU treatment effect the influence factors of patients with pregnancy,and to explore effects of HIFU treatment factors and impact on patients of reproductive function.Results:1.Among 166 patients with uterine fibroids and desire for futore fertility,a total of 82 pregnancies occurred among 75 women with 7 women having two pregnancies.The median follow-up time was 52 months,and the median pregnancy time was 16 months.Among the pregnant patients,65 cases were delivered successfully,3 cases were ongoing,and 14 cases were abortion(9 cases were spontaneous abortion,5 cases were induced abortion).Among the delivery patients,50 were delivered by caesarean section and 15 were delivered vaginally.All the 65 newborms survived and were healthy with a mean weight of(3.22±0.4)kg.Complications occurred in 4 cases during pregnancy,all of which recovered to normal postpartum.During delivery,no placenta implantation,postpartum hemorrhage or uterine rapture occurred.2.For patients with uterine fibroids with fertility requirements,the age of patients and history of spontaneous abortion before HIFU treatment are the influencing factors for pregnancy after HIFU treatment.After HIFU treatment,the pregnancy success rate of patients with a history of spontaneous abortion before HIFU treatment was higher than that of patients without a history of spontaneous abortion.Conclusions:HIFU treatment requires patients with uterine fibroids to have fertility,which preserves the fertility of patients with uterine fibroids.After treatment,patients with uterine fibroids can successfully conceive and get pregnant without serious complications during pregnancy and delivery,and all newborms are alive and healthy.Age of patients with uterine fibroids and history of spontaneous abortion before HIFU treatment were the inffluencing factors of pregnancy after HIFU treatment.After HIFU treatment,the pregnancy success rate of patients with a history of spontaneous abortion before treatment was higher than that of patients without a history of spontaneous abortion,suggesting that spontaneous abortion in patients with uterine fibroids is related to fibroids,and HIFU treatment of uterine fibroids may improve the birth disorder related to fibroids,which is worthy of further study.