Title: Maternal and Fetal Outcome in Fibroid Complicating Pregnancy in a Tertiary Care Centre
Authors: Dr Shahida J, Dr Rinku G, Dr Sapna Devi
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.56
Abstract
Background: Fibroid is the most common beningntumour of the uterus. Their incidence in pregnancy is between 1-2%.Complication can occur in 10-40% in the presence of fibroids.
Aim: The aim our study is to assess the maternal and fetal outcome in pregnancies complicated with fibroid of gestational age >28 weeks. Study setting: study conducted in Department of Obstetrics & Gynaecology, SAT Hospital which is a tertiary care centre attached to Government Medical College, Thiruvananthapuram.
Materials and Methods: This is a cohort study over a period of 2 years. The exposed group consists of pregnant patients with fibroid uterus and non exposed group consists of pregnant patients without fibroid uterus. The antepartum, intrapartum and postpartum complications and the fetal outcome were studied. Data analysis was done using statistical constants like mean, median, Odds ratio.
Results: Incidence of pregnancy with fibroid was 1 in231.64% belonged to the age group of 30-34 years.55% of patients were primiparous.34% of the patients remained asymptomatic during the antenatal period. There was a tenfold chance of developing abdominal pain during pregnancy mostly in intramural fibroids and with size >6cm,There was a 3 fold increased risk for placenta praevia and 3 fold increased risk for malpresentations in patients with fibroid uterus. Caesarean section rate was 2 times more in patients with fibroid. Mean gestational age of delivery was 38.05 weeks. Threatened, preterm labour was seen in 14.7% of patients with leiomyoma. PPH was 3 times more in the exposed group. Myomectomy was done along with caesarean section in 41.8% of patients.
Conclusion: Pregnancy with fibroid is associated with antepartum, intrapartum and post-partum complica-tions. Better antenatal care, prompt management of complications, good intrapartum care and neonatal care facilities in a tertiary care centre can improve the outcome in pregnancies complicated by fibroids.
Keywords: fibroid, leiomyoma, placenta praevia, caesarean section, myomectomy, malpresentation.