Pregnancy outcome in patients with fibroid

Antima Kirtikumar Maliwad, Rajal Thaker, Parul Shah


Background: Fibroids are benign smooth muscle cell tumour of the uterus. In some patients of pregnancy associated with fibroid, it does not affect the outcome of pregnancy. On the other hand, various complications have been reported. Objective of current study was to assess the prevalence and obstetric complications of fibroid during pregnancy and it management. 

Methods: This was a prospective study. The study was conducted at tertiary care centre, obstertrics & gynecology department over a period of nine months September 2013 to May 2014. Total 17 pregnant patients with >3 cm fibroid were included in the study. They were followed during antenatal period. Maternal age, parity, size of fibroid, complications during pregnancy, labour, and delivery, mode of delivery and indications of cesarean section were noted.  

Results: Incidence of fibroid during pregnancy was 0.4%. Out of 17 patients, majority 9 (52.9%) were between 26-30 years of age group, majority 7 (41.1%) were diagnosed between 21-28 weeks and 14 (82.3%) were multigravidas. Normal vaginal delivery occurred in 3 (20%), while 12 (80%) delivered by cesarean section. There were 8 (47%) patients who had no complication whereas 9 (52.9%) had some complication. Pain was present in 7 (41.1%). PROM and preterm labour was present in 3 (17.6%) and 2 (11.7%) respectively. Abortion and IUD occurred in 2 (11.7%) and in 1 (5.8%) respectively. LBW and IUGR was present in 5 (29.4%) and 3 (17.6%) respectively. PPH was present in 6 (35.2%). Antenatal myomectomy performed in 1 (5.8%) and myomectomy at cesarean section performed in 2 (11.7%). Blood transfusion was given to 8 (47%) patients.

Conclusions: Pregnant patients who have fibroids are to be carefully screened in the antenatal period, so as to have a regular follow up. The wide spread use of ultrasonography has facilitated diagnosis and management of fibroids in pregnancy. The site and size of fibroid is very important to predict its effect on the pregnancy. In selected patients, myomectomy during antenatal period and at cesarean section can give good results and better pregnancy outcome.  


Fibroid with pregnancy, Myomectomy

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Ouyang DW, Economy KE, Norwitz ER. Obstetric complications of fibroids. Obstet Gynaecol Clin North Am. 2006;33:153-69.

Suchitra P, Sanjay R, Ranjit A. Pregnancy with fibroid. In: Suchitra P, Sanjay R, Ranjit A, eds. Fibroids. 1st ed. Mumbai: The National Book Depot; 2006: 136-146.

Sheiner E, Bashiri A, Levy A, Hershkovitz R, Katz M, Mazor M. Obstetrics characteristics and perinatal outcome of pregnancies with uterine leiomyomas. J Reprod Med. 2004;49:182-6.

Qidwai GI, Caughey AB, Jacoby AF. Obstetric outcomes in women with sonographycally identified uterine leiomyomata. Obstet Gynaecol. 2006 Feb;107(2 Pt 1):376-82.

Shailesh Kaur, Anantta Pandole, Aparna Hegde, Sangeeta Kulkarni, Miti Ahuja, V. R. Ambiye. Pregnancy with fibroids. J Obstet Gynaecol India. 2004;54(4):361-2.

Klastsky PC, Tran ND, Caughey AB, Fujimoto VY. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstet Gynaecol 2008;19:357-66.

Benson CB, Chow JS, Chang-Lee W, Hill JA 3rd, Doubilet PM. Outcome of pregnancies in women with uterine leiomyomas identified by sonography in first trimester. Clin Ultrasound. 2001;29:261-264.

Matsunage E, Shiota K. Ectopic pregnancy and myoma uteri. Teratogenic effect and maternal characteristics. Teratology. 1980;21:61-6.

F. Gary Cunningham, Kenneth J. Leveno, Steven Bloom, John C. Hauth, Dwight J. Rouse, Catherine Y. Spong. Reproductive tract abnormality. In: F. Gary Cunningham, Kenneth J. Leveno, Steven Bloom, John C. Hauth, Dwight J. Rouse, Catherine Y. Spong, eds. Williams Obstetric. 23rd ed. New York: McGraw Hill Professional; 2009: 890-911.

Noor S, Fawwad A, Sultana R, Bashir R, Qurat-ul-ain, Jalil H, et al. Pregnancy with fibroids and its obstetrics complication. J Ayub Med Coll Abbottabad. 2009 Oct-Dec;21(4):37-40.

Rice JP, Kay HH, Mahony BS. The clinical significance of uterine leiomyomas in pregnancy. Am J Obstet Gynaecol. 1989;160:1212-6.

Blum M. Comparative study of serum CAP activity during pregnancy in malformed and normal uterus. J Perinatol Med. 1978;6:165-8.

Szamatowicz J, Laudanski T, Bulkszaz B, Akerlund M. Fibromyomas and uterine contractions. Acta Obstet Gynaecol Scand. 1997;76:973-6.

Hasan F, Arumugam K, Sivanesaratnam V. Uterine leiomyomata in pregnancy. Int J Gynaecol Obstet. 1991;34:45-8.

Vergani P, Locatelli A, Ghidini A, Andreani M, Sala F, Pezzullo JC. Large uterine leiomyomata and risk of cesarean delivery. Obstet Gynaecol. 2007 Feb;109(2 Pt 1):410-4.

De Carolis, Fatigante G, Ferrazzani S, Trivellini C, De Santis L, Mancuso S, et al. Uterine myomectomy in pregnant women. Fetal Diagn Ther. 2001;16:116.

Celik C, Acar A, Ciçek N, Gezginc K, Akyürek C. Can myomectomy be performed during pregnancy? Gynaecol Obstet Invest. 2002;53:79-83.