The impact of fibroid characteristics on pregnancy outcome

Abstract

Objective: To assess the influence of different characteristics of fibroids on pregnancy outcome.Study design: We identified women with fibroids ≥4 cm in size on ultrasonography at the dating scan between January 2002 and December 2012. The size (4-7cm, 7-10cm, >10cm), number (multiple/single), location (lower uterus/body of uterus) and type (intramural, combination of intramural/subserosal, subserosal) were ascertained. Medical records were reviewed to obtain pregnancy outcomes (preterm delivery, birth weight, mode of delivery, estimated blood loss, postpartum haemorrhage and admission for fibroid related pain).Results: 121 patients with 179 pregnancies were identified. Preterm delivery was more likely in those with multiple fibroids compared to single fibroids (18% v 6% p=0.05). The location of fibroid had an important effect on mode of delivery with a higher caesarean section rate for fibroids in the lower part of uterus than in the body of the uterus (86% v 40% p=0.01), a higher rate of postpartum haemorrhage (22% v 11%p=0.03) and greater estimated blood loss This information can be used to aid counselling women antenatally and in risk stratifying patients.

In vivo mechanisms of uterine myoma volume reduction with ulipristal acetate treatment

“…Symptoms manifest in 15%-30% of cases (3). This incapacitating pathology is responsible for complications, such as menometrorrhagia, leading to anemia, pelvic pain, and miscarriage, depending on the number, volume, and localization of myomas in the uterus (4). They constitute the first indication for hysterectomy (5).…”

Obstetrical Outcomes of Ultrasound Identified Uterine Fibroids in Pregnancy

“…Our findings are consistent with previous reports that suggest the presence of fibroids, large fibroids in particular, places women at a higher risk for Cesarean delivery and increased blood loss at delivery. 1,[3][4][5]7,10,11 The relationship we found between presence of large fibroids and higher blood loss was preserved after adjusting for BMI and mode of delivery. However, there was no significant difference in blood transfusions between fibroid and nonfibroid groups, and therefore, does not appear to be a large adverse clinical effect as these women are not necessarily requiring transfusions more frequently.…”

Twin pregnancies with uterine fibroids are not at increased risk for obstetric complications: single center cohort study

“…However, due to the relatively small sample size, we were not able to perform analysis by other characteristics of UFs. In two previous retrospective studies, preterm delivery was more common in multiple fibroids [23,24]. And in one study, fibroids in the lower part of uterus showed higher cesarean section rate, postpartum hemorrhage, greater estimated blood loss, and higher rates of admission for fibroid related pain [23].…”