Perinatal outcome of pregnancy after adenomyomectomy: summary of 10 cases with a brief literature review

• Published in: The journal of maternal-fetal & neonatal medicine 2020-12, Vol.33 (24), p.4145-4149
• Main Authors: Sugiyama, Mizuho, Takahashi, Hironori, Baba, Yosuke, Taneichi, Akiyo, Suzuki, Hirotada, Usui, Rie, Takei, Yuji, Ohkuchi, Akihide, Fujiwara, Hiroyuki, Matsubara, Shigeki
• Format: Article
• Language: English
• Subjects: Adenomyomectomy; Cesarean Section; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome - epidemiology; preterm delivery; Retrospective Studies; Tocolysis; Tocolytic Agents; Uterine Rupture
• ISSN: 1476-7058; 1476-4954
• DOI: 10.1080/14767058.2019.1597845

Objectives: The purpose of this study was the perinatal outcomes of patients who became pregnant after adenomyomectomy. Study design: The retrospective cohort study was performed involving pregnant women with a history of adenomyomectomy between 1 January 2011 and 31 December 2018. At 24-26 weeks, the patients were admitted even without symptoms or signs. When regular uterine contractions were observed, tocolysis was performed. Results: Ten patients were included. Elective and emergent cesarean section (CS) was performed in seven and three patients, respectively. Emergent CS was performed due to onset of labor (tocolytic failure) at 28, 24, and 32 weeks. Although no patients suffered uterine rupture, myometrial thinning was observed at the site corresponding to that of adenomyomectomy in three patients. Of these three patients, two required emergent CS due to tocolytic failure with cervical length (CL) shortening. In contrast, CLs were stable in the other seven patients with elective CS. Conclusions: Three patients after adenomyomectomy showed preterm delivery, and three had a very thin uterus to the extent that the fetus could be observed through the uterine wall. A short CL should be paid special attention in pregnant women with a history of adenomyomectomy.