IMPACT OF LEIOMYOMA IN PREGNANCY

Authors

  • Sarwat Navid
  • Shahida Arshad
  • Qurat -ul- Ain
  • Raabia Arshad Meo

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 Tumours

References

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.

Downloads

Published

2012-03-01

Most read articles by the same author(s)