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經子宮鏡進行子宮黏膜下巨大肌瘤切除術後成功妊娠分娩的個案報告
A Case Report of Pregnancy and Delivery after Large Submucosal Myoma Successfully Removed by Single-Session Hysteroscopic Myomectomy
摘要
本文為探討一位31歲不孕女性接受子宮黏膜下肌瘤切除手術後懷孕產子病例。此位婦女初到婦產科門診表示她的月經不規律，出血量很大。透過超音波檢查影像顯示子宮黏膜下有巨大的肌瘤，大小為6.2×4.6 cm^2，在門診先給予黃體素受體抑制劑抑制月經縮減肌瘤體積後，出血狀況獲得些微改善之後，在子宮鏡下切除肌瘤後經陰道將多塊肌瘤組織取出，最大尺寸達4.9 × 3.5 × 1.8 mm，重達47公克，術後治療狀況良好後，月經週期變為正常且無異常出血，然而ㄧ直無法順利懷孕，嘗試在其排卵後給予低劑量黃體素治療一直無法順利懷孕，直至調整到高劑量黃體素為800 mg/day時成功受孕著床，在懷孕四十周齡時順利生產一健康男嬰。我們介紹了一個有月經異常出血症狀的子宮黏膜下肌瘤的病例，子宮肌瘤切除術成功治療，術後順利懷孕生產。
並列摘要
This article discussesthe case of pregnancy and childbirth in a 31-year-old non-pregnant woman who underwent submucosal myomectomy. She went to the obstetrics and gynecology clinic and said that her menstruation was irregular and the bleeding was heavy. Submucosal fibroids of the uterus were shown through ultrasound images, with a size of 6.2 × 4.6 cm^2. Bleeding was slightly improved after the progesterone receptor inhibitor (Ulipristal) and hemostatic agent (Tranexamic acid) were first administered. She underwent hysteroscopic myomectomy to remove submucosa fibroids, which consisted of multiple pieces of gray-white soft tissue, the largest size was 4.9 × 3.5 × 1.8 mm, and the weight was 47 grams. The postoperative treatment was in good condition and normal menstruation. Successful pregnancy received high dose progesterone therapy after ovulation. She went to the obstetrics and gynecology department due to pain in the lower abdomen when she was 40 weeks pregnant. On the same day, she successfully gave birth to a healthy baby boy with a birth. We present a case of symptomatic uterine submucosal fibroids that were diagnosed before pregnancy and successfully treated with myomectomy, resulting in a successful pregnancy and delivery.