Fetomaternal outcome in pregnancies complicated by fibroid
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20212976Keywords:
Fibroid, Myoma, Myomectomy, Cross sectional study, Fetomaternal outcomeAbstract
Background: Fibromyoma (leiomyoma) is the most common benign tumour of the uterus. Approximately 10% to 30% of women with uterine fibroids developed complications during pregnancy. The aim of the study was planned to ascertain the fetomaternal outcome in pregnancies complicated by fibroid.
Methods: A hospital based cross-sectional study was conducted among pregnant women with documented uterine fibroid who was admitted for any complication or delivered in the department of obstetrics and gynaecology, RIMS, Imphal from September 2017 to August, 2019 in the department of obstetrics and gynaecology in collaboration with department of paediatrics, Regional institute of Medical Sciences, Imphal. Detailed clinical history and socio-demographic profile were recorded in pre-designed proforma. General physical examination and systemic examination and obstetrical examination was carried out for the participants.
Results: Major proportions was in the age group of 30-39 years (73.9%). Fibroids were more frequent in primigravida (76.1%) followed by P1 (15.2%) and ≥P2 (8.7%). Out of 46 patients 43 (93.5%) delivered by CS (69.76%), NVD (25.58%) and instrumental delivery (4.65%) while 3 patients (6.5%) undergo spontaneous abortions. Most common myoma found in this study was intramural (47.8%) followed by submucous (34.8%) and subserosal (17.4%). Out of 43 deliveries most common complications found was atonic PPH (6.97%) and placenta previa (6.97%) followed by degenerations (2.32%), abruptio placentae (2.32%), malpresentations (2.32%). Out of 43 deliveries 6.9% baby born with low birth weight, IUGR (6.9%), IUFD (4.6%), NICU admission (4.65%) and early neonatal death (2.32%).
Conclusions: Pregnancies with fibroids are considered as high-risk pregnancy associated with complications during the antepartum, intrapartum, postpartum period. Pregnant women with myoma can be advised for regular ANC along with TAS for early diagnosis and management of complication.
References
Paula J, Adams H. Benign Diseases of the Female Reproductive Tract. In: Jonathan SB, Rebecca DR, Timothy CH, eds. Berek and Novak’s Gynaecology. 14th ed. New Delhi: Lippincott Williams and Wilkins; 2007. 469-471.
Quyang DW, Norvitz ER. Management of pregnant women with leiomyomas, 2017. Available at: http://www.uptodate.com/patients/content/topic.do?topic key=~ ewppe YOKn3st Roe.com. Accessed on 02 June 2021.
Vollenhoven BJ, Lawrence AS, Healy DL. Uterine fibroids: a clinical review. Br J Obstet Gynaecol. 1990;97(4):285-98.
Katz VL, Dotters DJ, Doegmuller W. Complications of uterine leiomyomas in pregnancy. Obstet Gynaecol 1989;73(6):563-5.
Umezurike C, Waboso P. Successful myomectomy during pregnancy: a case report. Reprod health. 2005;2(1):2-6.
Rosati P, Bellati U, Exacoustos C, Angelozzi P, Mancuso S. Uterine myoma in pregnancy: ultrasound study. Int J Obstet Gynaecol 1989;28(2):109-17.
Akhtar N, Sultana S, Zabin F. Successful outcome of pregnancy with large fibroid uterus-A case report. Bangladesh J Obstet Gynaecol. 2013;25(2):87-9.
Wallach EE, Buttram VC, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril. 1981;36(4):433-45.
Wallach EE, Vu KK. Myomata uteri and infertility. Obstet Gynaecol Clin North Am. 1995;22(4):791-9.
Davis JL, Kay HH, Mazumder S, Habel CJ, Baley K, Sassoon D. Uterine leiomyomas in pregnancy: a prospective study. Obstet Gynecol. 1990;75:41-4.
Fleischer AC, Shah DM, Entman SS. Sonographic evaluation of maternal disorders during pregnancy. Radio Clin North Am. 1990;28(1):51-8.
Cornforth T. 10 things to know about uterine fibroid tumours, 2017. Available at: http://womenshealth.about.com/od/fibroidtnowabtfibroids.html. Accessed on 02 June 2021.
Ciavattini A, Clemente N, Delli CG, Giuseppe J, Giannubilo SR, Tranquilli AL. Number and size of uterine fibroids and obstetric outcomes. J Materl Fetal Neonatal Med. 2015;28(4):484-8.
Lefebvre G, Vilos G, Allaire C, Jeffrey J, Arneja J, Birch C, et al. The management of uterine leiomyomas. Obstet Gynaecol Can. 2003;25(5):396-418.
Strobelt N, Ghidini A, Cavallone M, Pensabene I, Ceruti P, Vergani P. Natural history of uterine leiomyomas in pregnancy. J Ultrasound med. 1994;13(5):399-401.
Phelan JP. Myomas and pregnancy. Obstet Gynecol Clin North Am. 1995;22(4):801-5.
Roberts WE, Fulp KS, Morrison JC, Martin JN. The impact of leiomyomas on pregnancy. Aust N Z J Obstet Gynaecol. 1999;39(1):43-7.
Forssman L. Distribution of blood flow in myomatous uteri as measured by locally injected 133Xenon. Acta Obstet Gynecol Scand. 1976;55(2):101-4.
Rice JP, Kay HH, Mahony BS. The clinical significance of uterine leiomyomas in pregnancy. A J Obstet Gynaecol. 1989;160(5):1212-6.
Javed M, Tariq R, Rashid M. Effect of Uterine Fibroid on Pregnancy Outcome. PJMHS. 2010;4(4):476-78.
Poovathi M, Ramalingam R. Maternal and Fetal Outcome in Pregnancy with Fibroids: A Prospective Study. Int J Sci Stud. 2016;3(11):169-72.
Radhika BH, Naik K, Shreelatha S, Vana H. Case series: pregnancy outcome in patients with uterine fibroids. JCDR. 2015;9(10):1.
Raja KS, Tasleem H. Effects of uterine leiomyoma on the course of pregnancy and labour. Rawal Med J. 2009;34(1):79-81.
Koike T, Minakami H, Kosuge S, Usui R, Matsubara S, Izumi A, et al. Uterine leiomyoma in pregnancy: its influence on obstetric performance. J Obstet Gynaecol Res. 1999;25(5):309-13.
Sarwar I, Habib S, Bibi A, Malik N, Parveen Z. Clinical audit of fetomaternal outcome in pregnancies with fibroid uterus. J Ayub Med Col Abbottabad. 2012;24(1):79-82.
Qidwai GI, Caughey AB, Jacoby AF. Obstetric outcomes in women with sonographically identified uterine leiomyomata. Obstet Gynaecol. 2006;107(2):376-82.
Coronado GD, Marshall LM, Schwartz SM. Complications in pregnancy, labor, and delivery with uterine leiomyomas: a population-based study. Obstet Gynaecol. 2009;95(5):764-9.
Klatsky PC, Tran ND, Caughey AB, Fujimoto VY. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. A J Obstet Gynaecol. 2008;198(4):357-66.
Saha MM, Mondal D, Biswas SC. Pregnancy with leiomyomas uteri and feto-maternal outcomes. Al Ameen J Med Sci. 2016;9(2):96-100.
Nasim A. Effects of fibroid on pregnancy and mode of delivery. J Med Sci. 2016;24(3):167-70.
Noor S, Fawwad A, Sultana R, Bashir R, Jalil H, Suleman N. Pregnancy with fibroids and its and its obstetric complication. J Ayub Med Col Abbottabad. 2009;21(4):37-40.
Tchente CN, Fogaing AD, Tejiokem MC, Nana PN, Mbu R, Leke R. Pregnancy outcome in a group of Cameroonian women with uterine fibroids. Gynecol Obstet Biol Reprod. 2009;38(6):493-9.
Shailesh K, Anahita P, Aparna H, Sangeeta K, Miti A, Ambuja VR. Pregnancy with fibroids. J Obstet Gynecol Ind. 2004 ;54(4):361-2.
Koike T, Minakami H, Kosuge S, Usui R, Matsubara S, Izumi A, et al. Uterine leiomyoma in pregnancy: its influence on obstetric performance. J Obstet Gynaecol Res. 1999;25(5):309-13.
Aydeniz B, Wallwiener D, Kocer C, Grischke EM, Diel IJ, Sohn C, et al. Significance of myoma-induced complications in pregnancy. A comparative analysis of pregnancy course with and without myoma involvement. Z Geburtshilfe Neonatol. 1998;202(4):154-8.
Hina K, Nudrat E, Tabassum S. Pregnancy associated with fibroids: complications and pregnancy outcome. J Coll Physicians Sugr Pak. 2002;12(12):731-4.
Andreani M, Vergani P, Ghidini A, Locatelli A, Ornaghi S, Pezzullo JC. Are ultrasonographic myoma characteristics associated with blood loss at delivery?. Ultrasound Obstet Gynecol. 2009;34(3):322-5.
Majeed T, Waheed FA, Sattar Y, Mobusher I, Saba K. Impact of uterine fibroids on the obstetric performance of the women; complications and pregnancy outcome. Pak J Med Sci. 2011;5:274-7.
Shahida J, Rinku G, Devi S. Maternal and fetal outcome in fibroid complicating pregnancy in a tertiary care centre. JMSCR. 2017;5(1):15543-46.
Dutta DC. Textbook of obstetrics including perinatology and contraception. 9th ed. New Delhi: Jaypee brothers medical publishers; 2017.
