1987년 11월부터 1992년 10월까지 이화대학병원 산부인과에 입원한 환자중 임신을 동반한 자궁근종환자 84례를 임신전 또는 산전에 진단된 30례와 분만시 우연히 발견된 54례의 두 군으로 나누어 임상적 특징을 비교 분석하여 다음과 같은 결과를 얻었다. 1. 임신을 동반한 자궁근종 환자중 자궁근종이 진단된 군에서 평균연령은30.5세, 분만시 발 견된 군에서 평균연령은 30.2세로 비슷하였으며, 초산부는 각각 83.3%, 75.9%로 차이가 없었 다. 자연유산의 기왕력이 있는 자궁근종 환자는 진단된 군에서 23.4%, 분만시 발견된 군에서 20.4%로 역시 차이가 없었다. 2. 자궁근종은 임상적 진찰이나 초음파검사에 의하여 임신전 또는 산전에 진단되었으며, 산전 에 발견되지 않은 환자들은 분만중에 우연히 발견되었다. 3. 자궁근종은 장막하 근종이 가장 많았으며, 진단된 군에서는 분만시 발견된 군에 비해 벽내 근종이 유의하게 증가하였고, 장막하 근종은 분만시 발견된 군이 진단된 군에 비해 유의하게 증가하였다. 자궁근종이 가장 많이 생기는 곳은 자궁체부의 전면이었으며, 두군간에 차이는 없었다. 4. 직경 4cm이상의 자궁근종은 임상적 진찰이나 초음파검사에 의해 진단이 되었고, 직경 6cm 이상의 자궁근종은 산전에 모두 진단이 되었다. 직경 2cm미만의 작은 자궁근종은 분만시에 우연히 발견되었으며, 진단된 군에 비해 유의하 게 증가하였다. 한 환자에서 2개이상의 자궁근종을 가진 다발성 자궁근종 환자는 진단된 군 과 분만시 발견된군간에 차이가 없었다. 5. 임신을 동반한 자궁근종 환자에서 임신의 결과는 만삭아 분만, 조산아 분만 및 자연유산으 로 귀결되었으며, 만삭아 분만은 분만시 우연히 발견된 군이 진단된 군에 비해 유의하게 증 가하였고, 자연유산은 진단된 군에서 분만시 발견된 군에 비해 유의하게 증가하였다. 6. 산과적 합병증으로는 조기진통 이상태위 진통장애 및 수술중 출혈 등이 있었는데, 조기진 통과 이상태위는 진단된 군과 분만시 발견된 군간에 차이가 없었고, 진통장애와 수술중 출혈 은 진단된 군에서 분만시 발견된 군에 비해 유의하게 증가하였다. 제거된 자궁근종의 병리조직 검사에서 볼 수 있는 이차적 변화는 변성, 괴사 및 낭성 변화 등이 있었는데 두군간에 차이는 없었다.

This study was undertaken to evaluate the effect of myoma on pregnancy. 30 pregnant women whose myomas were detected prior to pregnancy or during the antenatal care (detected group) and 54 pregnant women whose myomas were not detected until delivery (undetected group) participated in this study at the Department of Obstetrics and Gynecology, Ewha Womans University Hospital from the Nov. 1987 to Oct. 1992. Clinical manifestations such as mode of diagnosis, size of myoma, outcome of pregnancy and complications were analyzed between the patients of these two groups. The results were as follows: 1. Mean age of the patients in detected group and undetected group was 30.5 years and 30.2 years respectively. There was no difference in the proportion of primiparity (detected group: 83.3%, undetected group: 75.9%) and spontaneous abortion in the past history (detected group: 23.4%, undetected group: 20.4%) between the two groups. 2. Uterine myoma was detected by clinical examination and ultrasonogram prior to pregnancy or during the antenatal care in the patients of detected group and incidentally at delivery in the patients of undetected group. 3. The most common type of uterine myomas was subserosal myoma in the two groups. The proportion of intramural myoma was significantly higher in detected group than in undetected group, and subserosal myoma was more significantly higher in undetected group than in detected group. The most common location of uterine myoma was the anterior part of uterine corpus in the two groups and the proportion was not significantly different between the two groups. 4. Diameter 2 cm or more sized uterine myomas were detected by clinical examination and ultrasonogram and diameter 6cm or more sized uterine myomas were detected in all during the antenatal care. Small myomas less than 2cm in diameter were detected incidentally at delivery and the proportion was significantly higher in undetected group than in detected group. Multiple myomas were not significantly different in the proportion between the two groups. 5. Pregnancies with uterine myomas were ended to full term delivery, premature delivery and spontaneous abortion. The proportion of full term delivery was significantly higher in undetected group than in detected group and spontaneous abortion was significantly higher in detected group than in undetected group. 6. There was premature labor, abnormal presentation, obstructed labor, and operative bleeding in obstetric complications. The risks of premature labor and abnormal presentation were not significantly different between the two groups, but the risks of obstructed labor and operative bleeding were significantly higher in detected group than in undetected group. Secondary pathologic changes in the myomectomy specimen were degeneration, necrosis, and cystic change and there was not significantly different in the proportion between the two groups.