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中华产科急救电子杂志 ›› 2026, Vol. 15 ›› Issue (01) : 6 -10. doi: 10.3877/cma.j.issn.2095-3259.2026.01.003

妊娠合并子宫肌瘤

妊娠合并子宫肌瘤并发产后出血
陈艳红(), 吴惠婷   
  1. 510150 广州医科大学附属第三医院妇产科 广东省产科重大疾病重点实验室 广东省妇产疾病临床医学研究中心 粤港澳母胎医学高校联合实验室
  • 收稿日期:2025-11-05 出版日期:2026-02-18
  • 通信作者: 陈艳红

Pregnancy complicated by uterine fibroids and postpartum hemorrhage

Yanhong Chen(), Huiting Wu   

  • Received:2025-11-05 Published:2026-02-18
  • Corresponding author: Yanhong Chen
引用本文:

陈艳红, 吴惠婷. 妊娠合并子宫肌瘤并发产后出血[J/OL]. 中华产科急救电子杂志, 2026, 15(01): 6-10.

Yanhong Chen, Huiting Wu. Pregnancy complicated by uterine fibroids and postpartum hemorrhage[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2026, 15(01): 6-10.

妊娠合并子宫肌瘤是产科常见的合并症,需要警惕的并发症之一是产后出血。子宫肌瘤可通过改变子宫腔形态、影响子宫收缩力及胎盘附着位置等多种机制导致产后出血发生率高,病情重且处理复杂。本文主要探讨妊娠合并子宫肌瘤患者产后出血的发病率、高危因素、发病机制、治疗策略及妊娠结局。

Pregnancy complicated by uterine leiomyomas is a common obstetric condition, with postpartum hemorrhage (PPH) being a critical complication that warrants vigilance. Uterine leiomyomas are associated with a higher incidence of PPH, which often presents with greater severity and clinical complexity, due to mechanisms such as altered uterine cavity configuration, impaired uterine contractility, and abnormal placental implantation. This review focuses on the incidence, pathogenesis, management strategies, and pregnancy outcomes of PPH in patients with pregnancy complicated by uterine leiomyomas, aiming to improve maternal and neonatal safety and optimize pregnancy outcomes.

[1]
Murata T, Kyozuka H, Endo Y, et al. Preterm deliveries in women with uterine myomas: the Japan environment and children′s study[J]. Int J Environ Res Public Health202118(5):2246.
[2]
Tîrnovanu MC, Lozneanu L, Tîrnovanu D, et al. Uterine fibroids and pregnancy: a review of the challenges from a Romanian tertiary level institution[J]. Healthcare (Basel)202210(5):855.
[3]
Pavone D, Clemenza S, Sorbi F, et al. Epidemiology and risk factors of uterine fibroids[J]. Best Pract Res Clin Obstet Gynaecol201846:3-11.
[4]
Veronica M, Ali A, Venkateshwari A, et al. Association of estrogen and progesterone receptor gene polymorphisms and their respective hormones in uterine leiomyomas[J]. Tumour Biol201637(6):8067-8074.
[5]
Lou Z, Huang Y, Li S, et al. Global, regional, and national time trends in incidence, prevalence, years lived with disability for uterine fibroids, 1990-2019: an age-period-cohort analysis for the global burden of disease 2019 study[J]. BMC Public Health202323(1):916.
[6]
Choudhary A, Inamdar SA, Sharma U. Pregnancy with uterine fibroids: obstetric outcome at a tertiary care hospital of central India[J]. Cureus202315(2):e35513.
[7]
Milazzo GN, Catalano A, Badia V, et al. Myoma and myomectomy: poor evidence concern in pregnancy[J]. J Obstet Gynaecol Res201743(12):1789-1804.
[8]
Li H, Hu Z, Fan Y, et al. The influence of uterine fibroids on adverse outcomes in pregnant women: a meta-analysis[J]. BMC Pregnancy Childbirth202424(1):345.
[9]
冯烨,杨慧霞. 妊娠合并子宫肌瘤的诊疗新进展[J]. 中华妇产科杂志202560(5):399-402.
[10]
周梦玲,薛志伟,周淑. 妊娠合并子宫肌瘤的孕期变化及其与不良妊娠结局的关系[J/OL]. 中华妇幼临床医学杂志(电子版)202319(5):611-615.
[11]
Wang X, Wang G, Han R, et al. Uterine fibroids increase the risk of preterm birth and other adverse birth events: a systematic review and meta-analysis[J]. Transl Pediatr202211(6):978-986.
[12]
周晓. 孕期各型子宫肌瘤对胎儿发育及分娩前后的相关影响[J]. 当代医学201723(33):142-144.
[13]
Zhao R, Wang X, Zou L, et al. Adverse obstetric outcomes in pregnant women with uterine fibroids in China: a multicenter survey involving 112,403 deliveries[J]. PLoS One201712(11):e0187821.
[14]
王红梅,代荫梅. 子宫肌瘤对妊娠并发症的影响[J]. 中国妇产科临床杂志201617(1):86-89.
[15]
Shavell VI, Thakur M, Sawant A, et al. Adverse obstetric outcomes associated with sonographically identified large uterine fibroids[J]. Fertil Steril201297(1):107-110.
[16]
Ende HB, Lozada MJ, Chestnut DH, et al. Risk factors for atonic postpartum hemorrhage: a systematic review and meta-analysis[J]. Obstet Gynecol2021137(2):305-323.
[17]
Yunas I, Islam MA, Sindhu KN, et al. Causes of and risk factors for postpartum haemorrhage: a systematic review and meta-analysis[J]. Lancet2025405(10488):1468-1480.
[18]
Zaima A, Ash A. Fibroid in pregnancy: characteristics, complications, and management[J]. Postgrad Med J201187(1034):819-828.
[19]
Tian Y, Wang Q, Wang H, et al. Change of uterine leiomyoma size during pregnancy and the influencing factors: a cohort study[J]. Int J Gynaecol Obstet2022157(3):677-685.
[20]
Sarais V, Cermisoni GC, Schimberni M, et al. Human chorionic gonadotrophin as a possible mediator of leiomyoma growth during pregnancy: molecular mechanisms[J]. Int J Mol Sci201718(9):2014.
[21]
任璐璐,颜晓红,洪艺煌,等. 妊娠合并子宫肌瘤160例临床分析[J]. 中国实用妇科与产科杂志202137(7):778-781.
[22]
Coutinho LM, Assis WA, Spagnuolo-Souza A, et al. Uterine fibroids and pregnancy: how do they affect each other?[J]. Reprod Sci202229(8):2145-2151.
[23]
Chill HH, Karavani G, Rachmani T, et al. Growth pattern of uterine leiomyoma along pregnancy[J]. BMC Womens Health201919(1):100.
[24]
Rajuddin R, Oscar R, Dewi T P. Serum vascular endothelial growth factor levels and uterine fibroid volume[J]. Obstet Gynecol20208(2):107-111.
[25]
Flake GP, Moore AB, Sutton D, et al. The life cycle of the uterine fibroid myocyte[J]. Curr Obstet Gynecol Rep20187(2):97-105.
[26]
Yamaguchi T, Kyozuka H, Ito M, et al. Predicting postpartum hemorrhage in women undergoing planned cesarean section: a multicenter retrospective cohort study in Japan[J]. PLoS One202419(7):e0306488.
[27]
解珺淑,董薇,闫丹,等. 子宫肌瘤妊娠期变化及对母儿结局影响——372例临床分析[J]. 中国妇产科临床杂志202122(6):623-626.
[28]
Yaghoubian YC, Prasannan L, Alvarez A, et al. Fibroid size and number and risk of postpartum hemorrhage[J]. Am J Obstet Gynecol2023229(3):344-345.
[29]
Escobar MF, Nassar AH, Theron G, et al. FIGO recommendations on the management of postpartum hemorrhage 2022[J]. Int J Gynaecol Obstet2022157 Suppl 1(Suppl 1):3-50.
[30]
中华医学会妇产科学分会产科学组,中华医学会围产医学分会. 产后出血预防与处理指南(2023)[J]. 中华妇产科杂志202358(6):401-409.
[31]
卫焱星,黄莉萍. 缩宫素在防治产后出血临床应用中的过去、现在和未来[J/OL]. 中华产科急救电子杂志202514(3):139-143.
[32]
王红梅,代荫梅. 剖宫产术同时行子宫肌瘤剔除术的安全性研究进展[J]. 中华妇产科杂志202257(2):148-151.
[33]
潘玮辰,郑明明. 动脉栓塞术在严重产后出血中的应用[J/OL]. 中华产科急救电子杂志202514(3):144-146.
[34]
杜培丽,王志坚. 严重产后出血子宫切除的指征、时机及手术操作[J/OL]. 中华产科急救电子杂志202514(3):147-151.
[35]
Carroll M, Daly D, Begley CM. The prevalence of women′s emotional and physical health problems following a postpartum haemorrhage: a systematic review[J]. BMC Pregnancy Childbirth201616(1):261.
[36]
Latt SM, Alderdice F, Elkington M, et al. Primary postpartum haemorrhage and longer-term physical, psychological, and psychosocial health outcomes for women and their partners in high income countries: a mixed-methods systematic review[J]. PLoS One202318(6):e0274041.
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