気腹が妊娠子宮と胎児に対して与える影響

The effect of pneumoperitoneum on pregnant woman and fetus

　妊娠合併例に対する気腹の安全性は確立していない．今回，われわれは気腹法，吊り上げ法で行った症例の手術成績と予後を比較検討したが，気腹18例，吊り上げ12例の予後には差がなかった．次に5例で気腹中に経腟超音波断層法にて子宮動脈のpulsatility index（PI）を調べて子宮血管抵抗の変化を調べたが，気腹によりPIは次第に増大し，気腹を中止すると速やかに元に戻った．なお，胎児心拍数には変化は見られなかった．妊娠合併例に対する気腹は，適切な監視下で行われるならば母児に対する影響は少なく安全であると思われた．

The safety of pneumoperitoneum for pregnant women has not been established yet. We investigated the prognosis of women who underwent laparoscopy by gasless or pneumoperitoneal method. The uterine blood flow was examined by pulsatility index of uterine artery through transvaginal ultrasonography performed dur-ing surgery. There was no difference of prognosis between the two groups. The pulsatility index increased gradually according to the duration of pneumoperitoneum and returned when it was stopped. The pneumoperitoneum for pregnant women seemed to be safe when the uterine blood flow and the fetus are ob-served carefully.