High-risk pregnancy: fibroids and their impact on maternal and foetal health-insights from a prospective study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20243594Keywords:
Fibroids, Pregnancy, Preterm labor, Premature rupture of membranes, Intrauterine growth restrictionAbstract
Background: Uterine fibroids are common benign tumors affecting women of reproductive age, with significant implications during pregnancy. This study aimed to evaluate the maternal and fetal outcomes in pregnancies complicated by uterine fibroids.
Methods: A prospective observational study was conducted on 38 pregnant women with fibroids >2 cm diagnosed by ultrasonography. Patients were followed throughout pregnancy and postpartum period. Maternal characteristics, fibroid features, pregnancy complications, and fetal outcomes were analyzed.
Results: The mean age was 32.4 years, with 60.5% being primigravida. Intramural fibroids were most common (65.8%), followed by subserosal (28.9%) and submucosal (15.7%) including some patients with multiple fibroids. Common complications included preterm labor (26.3%), spontaneous abortion (15.8%), placental abnormalities (13.2%), and postpartum hemorrhage (21.1%). Caesarean section rate was 55.3%. Adverse fetal outcomes included small for gestational age (31.6%), preterm birth (26.3%), and NICU admission (23.7%).
Conclusions: Pregnancy with fibroids carries significant risks for both mother and fetus. Close antenatal surveillance and appropriate management strategies are essential for optimizing outcomes.
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References
Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-7.
Guo XC, Segars JH. The impact and management of fibroids for fertility: an evidence-based approach. Obstet Gynecol Clin. 2012;39(4):521-33.
Shavell VI, Thakur M, Sawant A, Kruger ML, Jones TB, Singh M, et al. Adverse obstetric outcomes associated with sonographically identified large uterine fibroids. Fertil Steril. 2012;97(1):107-10.
Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007;87(4):725-36.
Vitale SG, Tropea A, Rossetti D, Carnelli M, Cianci A. Management of uterine leiomyomas in pregnancy: Review of literature. Updates Surg. 2013;65(3):179-82.
Benaglia L, Cardellicchio L, Filippi F, Paffoni A, Vercellini P, Somigliana E, et al. The rapid growth of fibroids during early pregnancy. PloS one. 2014;9(1):e85933.
Hammoud AO, Asaad R, Berman J, Treadwell MC, Blackwell S, Diamond MP. Volume change of uterine myomas during pregnancy: Do myomas really grow? J Minim Invasive Gynecol. 2006;13(5):386-90.
Horiuchi A, Nikaido T, Yoshizawa T, Itoh K, Kobayashi Y, Toki T, et al. HCG promotes proliferation of uterine leiomyomal cells more strongly than that of myometrial smooth muscle cells in vitro. Mol Hum Reprod. 2000;6(6):523-8.
Pandit U, Singh M, Ranjan R. Assessment of maternal and fetal outcomes in pregnancy complicated by fibroid uterus. Cureus. 2022;14(2):e22052.
Wise LA, Palmer JR, Stewart EA, Rosenberg L. Age-specific incidence rates for self-reported uterine leiomyomata in the Black Women's Health Study. Obstet Gynecol. 2005;105(3):563-8.
Handa N, Anjali. Feto maternal outcomes of fibroid in pregnancy: a retrospective observational study. Int J Reprod Contracept Obstet Gynecol. 2023;12:3080-5.
Klatsky PC, Tran ND, Caughey AB, Fujimoto VY. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstet Gynecol. 2008;198(4):357-66.
Zhao R, Wang X, Zou L, Li G, Chen Y, Li C, et al. Adverse obstetric outcomes in pregnant women with uterine fibroids in China: A multicenter study involving 112,403 deliveries. PLoS One. 2017;12(11):0187821.
Noor S, Fawwad A, Sultana R, Bashir R, Qurat-ul-ain, Jalil H, et al. Pregnancy with fibroids and its obstetric complications. J Ayub Med Coll Abbottabad. 2009;21(4):37-40.
Sarwar I, Habib S, Bibi A, Malik N, Parveen Z. Clinical audit of feto-maternal outcome in pregnancies with fibroid uterus. J Ayub Med Coll Abbottabad. 2012;24(1):79-82.
