IMPACT OF LEIOMYOMA IN PREGNANCY
Abstract
Background: Uterine fibroids or leiomyomas are benign tumours that develop in the uterus, a femalereproductive organ. These cause severe complications in females during pregnancy. This study wasconducted to see the impact of leiomyoma in pregnant females to make decision for its management infuture. Methods: During one year of study, total 10,842 patients presented in CMH Lahore forantenatal check-up were included in the study. Out of them, 80 patients had leiomyoma in firsttrimester. They were followed during antenatal period. Maternal age, parity, size of fibroid,complications during pregnancy, labour and delivery, mode of delivery and indications of caesareansection were noted. Results: The prevalence of fibroids (≥5 Cm) in pregnant females was 0.74%. Themost common complication observed was PPH (31, 38.75%) cases. Miscarriage occurred in 8 (10%)cases, cord prolepses was observed in 6 (7.5%) cases, placental abruption in 6 (7.5%) cases, placentaprevia in 2 (2.5%) cases and retained placenta was observed in 1 (1.25%) case. Breech presentation wasfound in 10 (12.5%) cases and abdominal hysterectomy was done in 10 (12.5%) cases. Preterm labouroccurred in 8 (10%) cases and IUGR was present in 5 (6.25%) cases. No maternal was reported duringthe study. Among all females, 64 (80%) continue their pregnancy up to term (37–40 weeks ofgestation), out of which vaginal delivery occurred in 19 (29.69%) while 45 (70.3%) had LSCS due tofailure in progress in 17 (37.8%), cord prolapsed in 6 (13.3%) cases, fibroid in lower segment in 3(6.7%) cases, breech presentation in 10 (22.2%) cases and low lying placenta in 2 (4.4%) cases.Conclusion: Pregnancy with fibroid is associated with increase in caesarean section rate especially dueto dysfunctional labour and malpresentation. There is also increase in incidence of postpartumhaemorrhage and associated hysterectomy.Keywords: Leiomyoma, Uterine Fibroids, Benign Uterine TumoursReferences
Quyang DW, Norvitz ER. Management of pregnant women with
leiomyomas (fibroids). 2012. Available at:
http://wwwuptodatecompatients/content/topicdo?topicKey=~eW
ppcY0Kn3sfR0ecom.
Qidwai G, Caughey AB, Jacoby AF. Obstetric outcomes in
women with sonographically identified uterine leiomyomata.
Obstet Gynecol 2006;107(2, Part 1):376–82.
Ouyang DW, Economy KE, Norwitz ER. Obstetric
complications of fibroids. Obstet Gynecol Clin North Am
;33(1):153–69.
Exacoustòs C, Rosati P. Ultrasound diagnosis of uterine
myomas and complications in pregnancy. Obstet Gynecol
;82(1):97–101.
Rice J, Kay H, Mahony B. The clinical significance of uterine
leiomyomas in pregnancy. Am J Obstet Gynecol 1989;160(5 Pt
:1212–6.
Mason TC. Red degeneration of a leiomyoma masquerading as
retained products of conception. J Natl Med Asso
;94(2):124–6.
Friedman AJ. Leiomyomate Uteri. In: Quilligan EJ, Zuspan FP
(Eds). Current therapy in obstetrics and gynecology. 5th ed.
Philadelphia: Saunders; 1980. p. 97–107.
Kokab H, Elahi N, Shaheen T. Pregnancy associated with
Fibroids: Complications and pregnancy outcome. J Coll
Physicians Surg Pak 2002;12:731–4.
Muram D, Gillieson M, Walters J. Myomas of the uterus in
pregnancy: ultrasonographic follow-up. Am J Obstet Gynecol
;138(1):16–9.
Vollenhoven BJ, Lawrence A, Healy D. Uterine fibroids: a
clinical review. Br J Obstet Gynaecol 1990;97(4):285–98.
West GP. Uterine fibroids. In: Shaw RW, Soutter WP, Stanton
SL (Eds). Gynaecology. 2nd ed. USA: Chuchill Livingstone;
p. 441–56.
Youssef A, Ben Aissia N, Gara MF. Association fibromyoma
and pregnancy. About 23 cases. Tunis Med. 2005;83(4):194–7.
Benson CB, Chow JS, Chang-Lee W, Hill JA 3rd, Doubilet PM.
Outcome of pregnancies in women with uterine leiomyomas
identified by sonography in the first trimester. J Clin Ultrasound
;29(5):261–4.
Walker WJ, McDowell SJ. Pregnancy after uterine artery
embolization for leiomyomata: a series of 56 completed
pregnancies. Am J Obstet Gynecol 2006;195:1266–71.
Coronado GD, Marshall LM, Schwartz SM. Complications in
pregnancy, labor, and delivery with uterine leiomyomas: a
population-based study. Obstet Gynecol 2000;95:764–9.
Tchente Nguefack C, Fogaing AD, Tejiokem MC, Nana Njotang
P, Mbu R, Leke R. Pregnancy outcome in a group of
Cameroonian women with uterine fibroids. J Gynecol Obstet
Biol Reprod (Paris) 2009;38(6):493–9.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
