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中华产科急救电子杂志 ›› 2026, Vol. 15 ›› Issue (01) : 11 -15. doi: 10.3877/cma.j.issn.2095-3259.2026.01.004

妊娠合并子宫肌瘤

妊娠合并子宫肌瘤与流产
龙晟佳, 魏军()   
  1. 110000 沈阳,中国医科大学附属盛京医院妇产科 辽宁省母胎医学重点实验室
  • 收稿日期:2025-11-11 出版日期:2026-02-18
  • 通信作者: 魏军
  • 基金资助:
    国家重点研发计划(2023YFC2705903)

Pregnancy complicated by uterine fibroids and miscarriage

Shengjia Long, Jun Wei()   

  • Received:2025-11-11 Published:2026-02-18
  • Corresponding author: Jun Wei
引用本文:

龙晟佳, 魏军. 妊娠合并子宫肌瘤与流产[J/OL]. 中华产科急救电子杂志, 2026, 15(01): 11-15.

Shengjia Long, Jun Wei. Pregnancy complicated by uterine fibroids and miscarriage[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2026, 15(01): 11-15.

近年来妊娠期子宫肌瘤的检出率呈上升趋势。妊娠合并子宫肌瘤与流产风险升高存在关联,其中肌瘤的位置与数量可能是重要影响因素。其潜在机制可能包括宫腔解剖结构改变导致的内膜容受性下降、局部灌注不足等血流动力学异常,以及免疫炎症微环境失衡等。临床上,孕前应基于肌瘤分型、大小、数量及其对宫腔形态的影响进行评估。对影响宫腔形态的黏膜下肌瘤可考虑孕前切除。孕期妊娠合并子宫肌瘤者宜按高危妊娠进行管理,实施动态随访并及时处理相关并发症。本文系统总结妊娠合并子宫肌瘤与流产风险的最新循证医学证据,阐明其潜在机制,并提出基于肌瘤分型、大小与数量的孕前及孕期个体化管理策略,旨在为临床风险评估与规范化防治提供参考。

In recent years, the proportion of advanced maternal age pregnancies has increased, accompanied by a rising detection rate of uterine fibroids during pregnancy. Current evidence suggests an association between uterine fibroids complicating pregnancy and an elevated risk of miscarriage, with fibroid location and number potentially serving as key determinants. The underlying mechanisms may involve reduced endometrial receptivity secondary to alterations in uterine cavity anatomy, local hemodynamic disturbances such as impaired perfusion, and dysregulation of the inflammatory and immune microenvironment. Clinically, preconception evaluation should incorporate fibroid classification, size, number, and their impact on uterine cavity configuration. Submucosal fibroids that distort the uterine cavity may be considered for removal prior to conception. During pregnancy, women with uterine fibroids should be managed as high-risk, with serial surveillance and timely management of related complications. This review aims to synthesize the most up-to-date evidence regarding the relationship between uterine fibroids during pregnancy and miscarriage risk, elucidate potential mechanisms, and propose individualized preconception and antenatal management strategies based on fibroid type, size, and number, thereby informing clinical risk assessment and standardized prevention and management.

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