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目的探讨妊娠期卵巢子宫内膜异位症(内异症)的诊治方案以及复发因素。方法回顾性分析32例妊娠期卵巢内异症临床资料。结果本组术前诊断10例,剖宫产术中诊断22例,孕早期均未行妇科检查,孕中期B超检查卵巢均无阳性提示。6例妊娠期卵巢囊肿破裂,其中3例无症状,3例出现急性腹痛。32例均在孕晚期剖宫产术同时行患侧卵巢子宫内膜异位囊肿剔除术及盆腔病灶清除术、盆腔粘连松解术,术后病理检查证实为内异症。3例临床Ⅳ期在术后27～34个月复发,32例新生儿全部存活。结论妊娠期卵巢内异症诊断有一定困难,孕期可能发生囊肿破裂,可据临床症状及孕妇意见先行保守治疗,必要时手术。哺乳期或月经复潮后可口服去氧孕烯炔雌醇以降低复发率。
Objective To investigate the diagnosis and treatment of ovarian endometriosis (endometriosis) during pregnancy and its relapse factors. Methods Retrospective analysis of 32 cases of clinical data of ovarian endometriosis during pregnancy. Results The preoperative diagnosis of 10 cases, 22 cases of cesarean section diagnosis, gynecological examination did not go through the first trimester, the second trimester B-positive ovarian did not prompt. 6 cases of ovarian cyst rupture during pregnancy, 3 cases were asymptomatic, 3 cases of acute abdominal pain. 32 cases were in the third trimester cesarean section at the same time ipsilateral ovarian endometriosis cyst excision and pelvic lesions removal, pelvic adhesiolysis, postoperative pathology confirmed endometriosis. Three cases of clinical stage Ⅳ 27 to 34 months after the recurrence, 32 newborns all survived. Conclusion The diagnosis of ovarian endometriosis during pregnancy has some difficulties, cyst rupture may occur during pregnancy, according to clinical symptoms and views of pregnant women before conservative treatment, if necessary, surgery. Lactation or menstrual regurgitation can be oral administration of desogestrel ethinyl estradiol to reduce the recurrence rate.