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 was
conducted to see the impact of leiomyoma in pregnant females to make decision for its management in
future. Methods: During one year of study, total 10,842 patients presented in CMH Lahore for
antenatal check-up were included in the study. Out of them, 80 patients had leiomyoma in first
trimester. They were followed during antenatal period. Maternal age, parity, size of fibroid,
complications during pregnancy, labour and delivery, mode of delivery and indications of caesarean
section were noted. Results: The prevalence of fibroids (‰¥5 Cm) in pregnant females was 0.74%. The
most 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, placenta
previa in 2 (2.5%) cases and retained placenta was observed in 1 (1.25%) case. Breech presentation was
found in 10 (12.5%) cases and abdominal hysterectomy was done in 10 (12.5%) cases. Preterm labour
occurred in 8 (10%) cases and IUGR was present in 5 (6.25%) cases. No maternal was reported during
the study. Among all females, 64 (80%) continue their pregnancy up to term (37-40 weeks of
gestation), out of which vaginal delivery occurred in 19 (29.69%) while 45 (70.3%) had LSCS due to
failure 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 due
to dysfunctional labour and malpresentation. There is also increase in incidence of postpartum
haemorrhage and associated hysterectomy.
Keywords: Leiomyoma, Uterine Fibroids, Benign Uterine Tumours
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