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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(09): 535-539
DOI: 10.1055/s-0040-1713913
Original Article
Obstetrics/High Risk Pregnancy

The Effect of Small Size Uterine Fibroids on Pregnancy Outcomes in High-risk Pregnancies

Murat Cagan 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey
,
Atakan Tanacan 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey
,
Hanife Guler Donmez 
2   Department of Biology, Hacettepe University, Ankara, Turkey
,
Erdem Fadiloglu 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey
,
Canan Unal 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey
,
Mehmet Sinan Beksac 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey
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Abstract

Objective To evaluate the obstetric outcomes of singleton high-risk pregnancies with a small size uterine fibroid.

Methods This retrospective cohort study was conducted among 172 high-risk pregnant women who were followed-up by a single surgeon between 2016 and 2019. Pregnant women with preconceptionally diagnosed small size (< 5 cm) single uterine fibroids (n = 25) were compared with pregnant women without uterine fibroids (n = 147) in terms of obstetric outcomes.

Results There was no statistically significant difference between the groups in terms of adverse pregnancy outcomes. The size of the fibroids was increased in 60% of the cases, and the growth percentage of the fibroids was 25% during pregnancy. Intrapartum and short-term complication was not observed in women who underwent cesarean myomectomy.

Conclusion Small size uterine fibroids seem to have no adverse effect on pregnancy outcomes even in high-risk pregnancies, and cesarean myomectomy may be safely performed in properly selected cases.

Keywords

uterine fibroid - myoma - pregnancy - CS myomectomy

Contributors

All of the authors contributed with the project and the interpretation of the data, with the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.




Publication History

Received: 11 February 2020

Accepted: 21 May 2020

Article published online:
29 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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  • References

  • 1 Laughlin SK, Baird DD, Savitz DA, Herring AH, Hartmann KE. Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstet Gynecol 2009; 113 (03) 630-635 . Doi: 10.1097/AOG.0b013e318197bbaf
    CrossrefPubMedSearch in Google Scholar
  • 2 Stout MJ, Odibo AO, Graseck AS, Macones GA, Crane JP, Cahill AG. Leiomyomas at routine second-trimester ultrasound examination and adverse obstetric outcomes. Obstet Gynecol 2010; 116 (05) 1056-1063 . Doi: 10.1097/AOG.0b013e3181f7496d
    CrossrefPubMedSearch in Google Scholar
  • 3 Vitale SG, Tropea A, Rossetti D, Carnelli M, Cianci A. Management of uterine leiomyomas in pregnancy: review of literature. Updates Surg 2013; 65 (03) 179-182 . Doi: 10.1007/s13304-013-0198-z
    CrossrefPubMedSearch in Google Scholar
  • 4 Ezzedine D, Norwitz ER. Are women with uterine fibroids at increased risk for adverse pregnancy outcome?. Clin Obstet Gynecol 2016; 59 (01) 119-127 . Doi: 10.1097/grf.0000000000000169
    CrossrefPubMedSearch in Google Scholar
  • 5 Yalınkaya A, Kangal K, Güzel AI, Erdem S. Successful myomectomy of a giant myoma during pregnancy. Gynecol Obstet Reprod Med 2010; 16: 194-195
    PubMedSearch in Google Scholar
  • 6 Vitagliano A, Noventa M, Di Spiezio Sardo A, Saccone G, Gizzo S, Borgato S. , et al. Uterine fibroid size modifications during pregnancy and puerperium: evidence from the first systematic review of literature. Arch Gynecol Obstet 2018; 297 (04) 823-835 . Doi: 10.1007/s00404-017-4621-4
    CrossrefPubMedSearch in Google Scholar
  • 7 Rice JP, Kay HH, Mahony BS. The clinical significance of uterine leiomyomas in pregnancy. Am J Obstet Gynecol 1989; 160 (5 Pt 1): 1212-1216
    CrossrefPubMedSearch in Google Scholar
  • 8 Rosati P, Exacoustòs C, Mancuso S. Longitudinal evaluation of uterine myoma growth during pregnancy. A sonographic study. J Ultrasound Med 1992; 11 (10) 511-515 . Doi: 10.7863/jum.1992.11.10.511
    CrossrefPubMedSearch in Google Scholar
  • 9 Russo M, Suen M, Bedaiwy M, Chen I. Prevalence of uterine fibroids among women with two or more recurrent pregnancy losses: a systematic review. J Minim Invasive Gynecol 2016; 23 (05) 702-706 . Doi: 10.1016/j.jmig.2016.03.018
    CrossrefPubMedSearch in Google Scholar
  • 10 Diamond MP, Polan ML. Intrauterine synechiae and leiomyomas in the evaluation and treatment of repetitive spontaneous abortions. Semin Reprod Med 1989; 7 (02) 111-114 . Doi: 10.1055/s-2007-1021389
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Turgal M, Ozgu-Erdinc AS, Beksac K, Ozyuncu O, Karaagaoglu E, Beksac MS. Myomectomy during cesarean section and adhesion formation as a long-term postoperative complication. Ginekol Pol 2015; 86 (06) 457-460 . Doi: 10.17772/gp/2404
    CrossrefPubMedSearch in Google Scholar
  • 12 Chauhan AR. Cesarean myomectomy: necessity or opportunity?. J Obstet Gynaecol India 2018; 68 (06) 432-436 . Doi: 10.1007/s13224-018-1114-8
    CrossrefPubMedSearch in Google Scholar
  • 13 Beksaç MS, Aydın E, Tuğral M, Karaağaoğlu E. An obstetrics index for the assessment of risk levels of “high risk pregnancy” groups. Gynecol Obstet Reprod Med 2016; 21 (01) 10-13
    PubMedSearch in Google Scholar
  • 14 Beksac K, Tanacan A, Cagan M. , et al. Relationship of cholelithiasis and urolithiasis with methylenetetrahydrofolate reductase polymorphisms. J Investigative Surg 2020
    PubMedSearch in Google Scholar
  • 15 Tanacan A, Beksac MS, Orgul G, Duru S, Sener B, Karaagaoglu E. Impact of extractable nuclear antigen, anti-double stranded DNA, antiphospholipid antibody, and anticardiolipin antibody positivity on obstetrical complications and pregnancy outcomes. Hum Antibodies 2019; 27 (02) 135-141 . Doi: 10.3233/HAB-180359
    CrossrefPubMedSearch in Google Scholar
  • 16 Krimou Y, Erraghay S, Guennoun A, Mamouni N, Bouchikhi C, Banani A. Myoma praevia and pregnancy. Pan Afr Med J 2019; 33: 216 . Doi: 10.11604/pamj.2019.33.216.14898
    PubMedSearch in Google Scholar
  • 17 Ouyang DW, Economy KE, Norwitz ER. Obstetric complications of fibroids. Obstet Gynecol Clin North Am 2006; 33 (01) 153-169 . Doi: 10.1016/j.ogc.2005.12.010
    CrossrefPubMedSearch in Google Scholar
  • 18 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 (04) 357-366 . Doi: 10.1016/j.ajog.2007.12.039
    CrossrefPubMedSearch in Google Scholar
  • 19 Parazzini F, Tozzi L, Bianchi S. Pregnancy outcome and uterine fibroids. Best Pract Res Clin Obstet Gynaecol 2016; 34: 74-84 . Doi: 10.1016/j.bpobgyn.2015.11.017
    CrossrefPubMedSearch in Google Scholar
  • 20 Navid S, Arshad S, , Qurat-ul-Ain, Meo RA. Impact of leiomyoma in pregnancy. J Ayub Med Coll Abbottabad 2012; 24 (01) 90-92
    PubMedSearch in Google Scholar
  • 21 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 (01) 107-110 . Doi: 10.1016/j.fertnstert.2011.10.009
    CrossrefPubMedSearch in Google Scholar
  • 22 Coronado GD, Marshall LM, Schwartz SM. Complications in pregnancy, labor, and delivery with uterine leiomyomas: a population-based study. Obstet Gynecol 2000; 95 (05) 764-769 . Doi: 10.1016/s0029-7844(99)00605-5
    PubMedSearch in Google Scholar
  • 23 Vitale SG, Padula F, Gulino FA. Management of uterine fibroids in pregnancy: recent trends. Curr Opin Obstet Gynecol 2015; 27 (06) 432-437 . Doi: 10.1097/gco.0000000000000220
    CrossrefPubMedSearch in Google Scholar
  • 24 Aharoni A, Reiter A, Golan D, Paltiely Y, Sharf M. Patterns of growth of uterine leiomyomas during pregnancy. A prospective longitudinal study. Br J Obstet Gynaecol 1988; 95 (05) 510-513 . Doi: 10.1111/j.1471-0528.1988.tb12807.x
    CrossrefPubMedSearch in Google Scholar
  • 25 Song D, Zhang W, Chames MC, Guo J. Myomectomy during cesarean delivery. Int J Gynaecol Obstet 2013; 121 (03) 208-213 . Doi: 10.1016/j.ijgo.2013.01.021
    CrossrefPubMedSearch in Google Scholar