Navigating Pyomyoma in Pregnancy and Postpartum: A Systematic Review

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada Pub Date : 2025-02-18 DOI:10.1016/j.jogc.2025.102791

Saboohi Tariq MBBS , Parijot Kumar MB BCh BAO , Conor Harrity MD , Kushal Chummun MD , Fadi Salameh MB BCh BAO , Micheal Geary MB BCh BAO, MD, DCH , Hassan Rajab DGO, MD

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引用次数: 0

Abstract

Objective

To assess the different presentations of pyomyoma in pregnant and postpartum populations, and review the treatment modalities.

Data Sources

This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We performed a comprehensive search of PubMed, Scopus, Google Scholar and Embase during the years 1945 to October 2024.

Study Selection

Included case reports assessed the types of intervention (hysterectomy, myomectomy, or other forms of treatments) to treat Pyomyoma. All case studies confirming a diagnosis of pyomyoma on either operative and/or histological findings were eligible. A total of 123 studies were initially screened and after a full-text evaluation, 40 articles with a total of 43 cases were included in this systematic review.

Data Extraction and Synthesis

Pyrexia and abdominal pain were the most common presenting symptoms found in 79% and 77% of patients, respectively. The most common causative organism was E-Coli (23%). Hysterectomy was performed in a total of 13 (30%) patients, myomectomy in 24 (56%) patients and 6 (14%) patients were treated conservatively.

Conclusions

Given the considerable morbidity associated with pyomyoma, the benefits of surgical treatment tend to outweigh the potential risks. However, since pregnant and postpartum women are a younger cohort and fertility is a concern, myomectomy is preferred to hysterectomy.

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妊娠和产后子宫肌瘤的导航：系统综述。

背景：子宫肌瘤是一种罕见但严重的妊娠期和产后并发症，可导致孕妇和胎儿严重发病。子宫肌瘤的常见症状包括腹痛、盆腔疼痛和发热：评估子宫脓肌瘤在孕妇和产后人群中的不同表现，并回顾治疗方法：设计：本系统性综述遵循 PRISMA 指南进行。我们对1945年至2024年10月期间的PubMed、Scopus、Google Scholar和Embase进行了全面检索：纳入的病例报告评估了治疗子宫肌瘤的干预类型（子宫切除术、肌瘤切除术或其他治疗方式）。所有根据手术和/或组织学结果确诊为脓肌瘤的病例研究均符合条件。初步筛选出123项研究，经过全文评估后，40篇文章共43个病例被纳入本系统综述：热病和腹痛是最常见的症状，分别占患者总数的79%和77%。最常见的致病菌是大肠杆菌（23%）。共有13名（30%）患者接受了子宫切除术，24名（56%）患者接受了肌瘤切除术，6名（14%）患者接受了保守治疗：鉴于脓肌瘤的发病率相当高，手术治疗的益处往往大于潜在风险。不过，由于孕妇和产后妇女的年龄较小，而且生育能力也是一个问题，因此子宫肌瘤切除术比子宫切除术更受青睐。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of obstetrics and gynaecology Canada OBSTETRICS & GYNECOLOGY-

CiteScore

3.30

自引率

5.60%

发文量

302

审稿时长

32 days

期刊介绍： Journal of Obstetrics and Gynaecology Canada (JOGC) is Canada"s peer-reviewed journal of obstetrics, gynaecology, and women"s health. Each monthly issue contains original research articles, reviews, case reports, commentaries, and editorials on all aspects of reproductive health. JOGC is the original publication source of evidence-based clinical guidelines, committee opinions, and policy statements that derive from standing or ad hoc committees of the Society of Obstetricians and Gynaecologists of Canada. JOGC is included in the National Library of Medicine"s MEDLINE database, and abstracts from JOGC are accessible on PubMed.