Analysis Of Pregnancy Outcomes In Patients With Uterine Fibroids After High Intensity Focused Ultrasound Treatment

Objective: To investigate the effect of high intensity focused ultrasound(HIFU,high intensity focused ultrasound)on pregnancy outcomes in patients with uterine fibroids.Methods: From October 2010 to October 2017,241 patients with uterine fibroids who were pregnant after HIFU treatment in Suining Central Hospital and Chongqing Haifu Hospital were retrospective analyzed.The efficacy of HIFU ablation and the patient’s pregnancy outcomes were investigated.Results: Among these patients,9 of them were conceived within 2 month after HIFU,24 of them were conceived between 2 and 4 months after HIFU,33 of them were conceived between 4 and 6 months,and 175 of them were conceived after 6 months after HIFU.The median conception time was 9 months after HIFU(range:1 to 26 months).The uterine volume of 175 pregnant patients was significantly reduced after 2,4 and 6 months compared with that before treatment.And the rate of uterine volume reduction was gradually increased with time(P < 0.01).The lesion volume of 175 patients was significantly reduced after 2,4 and 6 months compared with that before treatment,and the lesion volume gradually decreased with time(P<0.01).The PBAC scores of 175 patients were significantly different from those before treatment,and the PBAC scores were gradually decreased as time went on(P<0.01).The menstrual periods of 175 patients were significantly different from those before treatment,and the menstrual periods were gradually shortened as time went on(P < 0.01).The pregnancy outcomes of the 241patients: 241 patients had 247 pregnancies(6 patients had 2 pregnancies).237 patients had natural conception and 4 patients assisted reproductive technology.152 of them had delivered successfully,12 were still pregnant,3 were ectopic pregnancy,2 were incision pregnancy,66 were induced abortion and 6 were spontaneous abortion.Of the 152 patients who had given birth,147 had 148 full-term births(1 had two full-term births)and 5 had premature delivery.No uterine rupture occurred during pregnancy or during delivery.And all newborns were healthy.Causes of induced abortion include: embryonic development(8cases),increased vaginal bleeding(5 cases),use of drugs during pregnancy,fear of fetal malformation(6 cases),unplanned pregnancy(52 cases).No serious adverse effect or complications was observed in any of the 241 patients after HIFU.Conclusion:(1)HIFU not only has the advantages of small damage to normal tissues,short time consumption and fast recovery after treatment,but also can effectively alleviate the clinical symptoms of patients by reducing the volume of uterus and lesions.(2)For patients with fertility requirements,HIFU can shorten contraceptive time and no increased risk of uterine rupture during pregnancy.(3)HIFU may also help improve fertility outcomes.The pregnancy outcomes were good after HIFU treatment.The rates of preterm birth and miscarriage are both lower than the range of statistics in obstetrics and gynecology.It means that HIFU is a better treatment for patients with fertility requirements.