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Objective:To estimate the safety of myomectomy in twin pregnant women with intramural myomas during cesarean section.Methods:The clinical data of 145 cases of twin pregnancies with intramural myomas who were delivered by cesarean section in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from June 2013 to December 2021 were collected. Maternal demographics, fibroids′ characteristics, maternal and fetal outcomes were compared between groups of cesarean section with myomectomy (myomectomy group, 49 cases) and cesarean section only (non-myomectomy group, 96 cases).Results:Compared with non-myomectomy group, myomectomy group had significantly prolonged operative time [50.0 minutes (37.5-57.5 minutes) vs 40.0 minutes (35.0-50.0 minutes), respectively; P=0.007] and significantly longer postoperative hospital stay [4.0 days (3.0-4.0 days) vs 3.0 days (3.0-4.0 days), respectively; P=0.047). Other maternal and fetal outcomes such as estimated blood loss, hemoglobin difference, postpartum hemorrhage, blood transfusion, B-Lynch structure, uterine artery ligation, postoperative fever and neonatal Apgar score showed no significant differences (all P>0.05). For intramural myomas <5 cm, there were no significant differences in maternal and fetal outcomes between myomectomy group and non-myomectomy group (all P>0.05). For intramural myomas ≥5 cm, operative time [55.0 minutes (40.0-60.0 minutes) vs 42.5 minutes (40.0-50.0 minutes), respectively; P=0.019] was significantly prolonged, postoperative hospital stay [4.0 days (4.0-5.0 days) vs 4.0 days (3.0-4.0 days), respectively; P=0.048] was significantly longer in myomectomy group than non-myomectomy group, but there were no significant differences in other maternal and fetal outcomes (all P>0.05). Conclusion:For twin pregnancies with intramural myomas, it is safe and feasible to remove intramural myomas during cesarean section by experienced obstetricians.
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Objective To establish the healthcare management mode for pregnant women adapting to the characteristics of transient population which can safeguard the maternal and infant health or reduce the maternal mortality rate and prenatal mortality rate. Methods Five suburban communities of Chaoyang District, Haidian District and Fengtai District of Beijing were chosen as intervention group, which received systemic healthcare management of pregnant women in transient population, another five suburban communities were selected as control group. Results Both maternal mortality rate and prenatal mortality rate in intervention group were lower than those in control group. To evaluate the effect of systemic healthcare for pregnant women, an average of four antenatal clinic visits were completed in intervention group and eight visits in control group. There was no statistical difference in occurrence of maternal complications, newborn weight and occurrence rate of neonatal asphyxia between two groups. The expense of hospital vaginal delivery was no more than 1000 yuan in intervention group and more than 1000 yuan in control group, while the outcomes of mothers and neonates in two groups had no significant difference. Conclusion The systemic healthcare and community management mode for pregnant women in transient population can safeguard the maternal and infant health with scientific, practical, and replica-ble significances.