Uterine fibroids at routine second-trimester ultrasound survey and risk of sonographic short cervix

Blitz, Matthew J.; Rochelson, Burton; Augustine, Stephanie; Greenberg, Meir; Sison, Cristina; Vohra, Nidhi

doi:10.3109/14767058.2015.1131261

Cited by 11 publications

(23 citation statements)

References 27 publications

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“…Blitz et al investigated whether pregnant women with uterine leiomyoma are at higher risk for a short cervix. 18 According to this retrospective study, they reported 5.1% leiomyomas prevalence in pregnant patients. In this study the authors evaluated the pregnant women with gestational age of 17-23 weeks and found significantly higher short cervix (<25 mm) incidence (3.6%) in pregnant patients with leiomyoma than healthy pregnant controls (1.5%).…”

Section: Discussionmentioning

confidence: 87%

The Evaluation of Uterine Leiomyoma Prevalence and Its Effect on Cervical Length During Mid-Trimester Ultrasound Scan

Karadağ¹,

Akar²,

Gönenç³

et al. 2019

JCOG

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136 eiomyomas are the most common benign tumors of the female reproductive tract and have a prevalence of 30% to 70% among women of reproductive age. 1 Leiomyomas are seen in about 3%-12% of pregnant women. 2,3 Often, uterine leiomyomas are incidentally discovered during ultrasound examinations. 4 Previous studies have shown increased obstetric complications in pregnant patients with leiomyomas. 5Leiomyomas are frequently observed in pregnancy and are concerning because of negative obstetric outcomes, such as increased risk of missed abortions, preterm birth, abruptio placenta, premature rupture of membranes (PPROM), malpresentation of fetus, dystocia, cesarean delivery, postpartum hemorrhage, and hysterectomy. [6][7][8] There has been controversy regarding the relation between uterine leiomyomas and the increased risk of preterm birth. While many studies have reported an increased risk of preterm birth for pregnant women with leiomyomas; other studies have reported no relationship. [7][8][9][10][11][12] The underlying mechanisms of preterm labor and leiomyomas remain unclear and previous studies have elucidated that a short cervix is a potential outcome in pregnant patients with leiomyomas. 7,8 The Evaluation of Uterine Leiomyoma Prevalence and Its Effect on Cervical Length During Mid-Trimester Ultrasound Scan A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : This study aims to investigate the effects of uterine leiomyomas' on cervical length in pregnant women during mid-trimester ultrasound scan. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : In this study, 1908 pregnant women aged 18-44 years were evaluated via abdominal and transvaginal ultrasounds in the mid-trimester (18-24 weeks). The number, size, type and location of the leiomyomas were screened and recorded. Cervical length was measured transvaginally on an empty bladder. Short cervix was defined as lower than 25 mm. Pregnant women with leiomyoma were compared with pregnant women without leiomyoma regarding cervical length and short cervix incidence. R Re es su ul lt ts s: : Eighty (4.2%) patients were diagnosed with uterine leiomyoma and the mean diameter of uterine leiomyomas was 31.4 mm. The mean cervical length of the leiomyoma group was significantly lesser than that in pregnant women without leiomyomas (p=0.001). The number of women with a short cervix was higher in the leiomyoma group than the controls (p=0.001). There was a significant positive correlation between age and leiomyoma prevalence (r=0.294, p=0.021).There was a significant negative correlation between myoma size and cervical length in women with only one leiomyoma (r=-0.325, p=0.015). C Co on nc cl lu us si io on n: : Pregnant women with leiomyoma have higher incidence of short cervix. Leiomyomas could negatively affect cervical length.

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Section: Discussionmentioning

confidence: 87%

The Evaluation of Uterine Leiomyoma Prevalence and Its Effect on Cervical Length During Mid-Trimester Ultrasound Scan

Karadağ¹,

Akar²,

Gönenç³

et al. 2019

JCOG

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“…Finally, 19 articles (18 studies) were included in this meta-analysis. [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] One of these papers reported complementary information to the primary outcome information. 35,38 The selection process is shown in Figure 1.…”

Section: General Characteristics Of Studiesmentioning

confidence: 99%

“…There were five cohort studies, including 3449 pregnant women with UF and 111 644 control women without UF reported in five articles. 26,33,35,38,41 There were also 13 case-control studies, including 10 270 pregnant women with UF and 150 795 control women without UF. 24,25,[27][28][29][30][31][32][34][35][36][37]40,42 In all included studies, the presence or absence of UF was determined by ultrasound examination during the first or second trimesters of gestation.…”

Section: General Characteristics Of Studiesmentioning

confidence: 99%

“…Characteristics of the included studies and participants are displayed in Table 1. Five populations were studied in the United States, 26,29,30,35,39 seven in Europe, 24,25,28,[32][33][34]41 three in Asia, 27,36,42 two in Africa 31,40 and one in Mexico. 37 Two articles reported different results of the same cohort.…”

Section: General Characteristics Of Studiesmentioning

confidence: 99%

“…[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] In 10 studies, pregnant women with UF were older than those without fibroids (MD = 2.40 years, 95% CI 0.94-3.85, P < 0.001). [24][25][26][30][31][32][33]37,39,40 Six studies also showed the association of UF with preterm birth <34 weeks (RR = 1.79, 95% CI 1.32-2.42, P < 0.001; I 2 = 68%; Figure 2b). 24,26,32,33,36,39 These two associations (<37 and <34 weeks) had moderate degrees of heterogeneity.…”

Section: Preterm Birth and Gestational Age At Deliverymentioning

confidence: 99%

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Uterine fibroids and preterm birth risk: A systematic review and meta‐analysis

Pérez-Roncero

López‐Baena

Ornat

et al. 2020

J of Obstet and Gynaecol

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Aim This study explored the association between the presence of uterine fibroids (UF), as determined by ultrasound, and preterm birth (PB) risk. Methods Medline, Embase, Cochrane, Scopus and Web of Science databases. Studies reporting women with and without UF demonstrated by an ultrasound exam. The primary outcome was the risk of PB < 37 weeks of gestation in pregnancies with UF diagnosed by an obstetric ultrasound exam. Effects for dichotomous and continuous outcomes are, respectively, reported as risk ratios (RR) or mean differences and their 95% confidence intervals (CI). Results Eighteen studies were included comprising 276 172 pregnancies to whom obstetric ultrasound assessment was performed for the presence/absence of UF. Women with UF were older (mean difference = 2.40 years, 95% CI 0.94–3.85) and were at higher risk of PB before 37 (RR = 1.43, 95% CI 1.27–1.60), 34 (RR = 1.79, 95% CI 1.32–2.42), 32 (RR = 1.94, 95% CI 1.33–2.85) and 28 (RR = 2.17, 95% CI 1.48–3.17) weeks as compared to those without UF (P < 0.01). In addition, women with UF were at higher risk of threatened preterm labor, preterm premature rupture of membranes, fetal malpresentation, placental abruption, lower gestational age and birthweight at delivery and a higher cesarean delivery rate. Conclusion Pregnant women with UF are at increased risk of PB and other adverse obstetric outcomes.

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Uterine Fibroids and Infertility

Donnez¹,

Donnez²,

Arriagada³

et al. 2019

Encyclopedia of Endocrine Diseases

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Uterine fibroids at routine second-trimester ultrasound survey and risk of sonographic short cervix

Abstract: Women with uterine fibroids may be at higher risk for a short cervix. Fibroids are also associated with several adverse obstetric and neonatal outcomes.

Cited by 11 publications

References 27 publications

The Evaluation of Uterine Leiomyoma Prevalence and Its Effect on Cervical Length During Mid-Trimester Ultrasound Scan

The Evaluation of Uterine Leiomyoma Prevalence and Its Effect on Cervical Length During Mid-Trimester Ultrasound Scan

Uterine fibroids and preterm birth risk: A systematic review and meta‐analysis

Uterine Fibroids and Infertility

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