Analysis of pregnancy outcomes and influencing factors in patients with uterine fibroid after focused ultrasound ablation surgery
Objective To study the pregnancy outcomes in patients with uterine fibroids who desire future fertility after focused ultrasound ablation surgery(FUAS)and further analyze factors influencing pregnancy outcomes.Methods A to-tal of 892 patients with uterine fibroids who desired future fertility and received FUAS treatment at Chongqing Haifu Hos-pital from April 2011 to December 2022 were retrospectively analyzed.Pregnancy outcomes were followed up and factors affecting pregnancy outcomes were analyzed through multivariate analysis.Results Among the 892 patients,113 pa-tients who were unmarried or divorced,and 82 patients who were lost to follow-up within 6 months after the procedure were excluded.Finally,697 patients were enrolled.(1)Among them,283 patients were pregnant at a median of 6.0(3.0,10.0)months after FUAS,with a total of 288 pregnancies,and the post-FUAS pregnancy rate was 40.6％(283/697).(2)Among the 283 pregnant patients,69(24.4％)had a history of adverse pregnancy,and 51(18.0％)were infertile.(3)At the end of follow-up(October 2023),256 patients had 261 times of successful deliveries,11 patients were still in preg-nancy,and 16 patients had miscarriage.(4)None of the 283 patients had a uterine rupture during pregnancy or delivery.Among the 256 patients who had given birth,only 14(5.5％)patients suffered from postpartum complications.(5)Of the 262 newborns(1 twins),11 suffered from neonatal asphyxia,of whom 1 case of Fallot's tetralogy underwent elective sur-gery,while the other infants were doing well.(6)Statistical analysis showed a significant difference in age,type of fi-broids,number of fibroids,non-perfused volume(NPV)and NPV ratio between the group of pregnant patients and the group of non-pregnant patients(P＜0.05).(7)A sig-nificant differences in number of fibroids,NPV and NPV ratio were also observed between patients in normal deliv-ery group and the miscarriage group(P＜0.05).Conclusions FUAS is a safe and effective treatment for patients with uterine fibroids who wish to conceive.The time to conception after FUAS is short,and the pregnancy outcomes are im-proved,which does not affect the delivery or increase obstetric risks.The older age,multiple fibroids,submucosal fi-broids,the limited NPV and the low NPV ratio have negative effects on pregnancy.The main factors influencing pregnan-cy outcome are the number of fibroids,NPV and NPV ratio.
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