Title: Effect of Fibroid on Pregnancy and Pregnancy on Fibroid Uterus
Authors: Dr Sufia Begum (FCPS), Dr Mahina Monsur, Dr Ummul Nusrat Zahan (FCPS)
DOI: http://dx.doi.org/10.18535/jmscr/v4i3.11
Objective: We study the effect of fibroids on women with pregnancy and pregnancy on uterine leiomyoma (fibroids) documented by ultrasonography. Materials and Methods: Fifty (50) pregnant women diagnosed with leiomyoma during pregnancy were evaluated clinically and sonographycally. The number, size and location of the fibroid were observed with their impact on pregnancy outcome. Result: Our study population consisted of fifty pregnant women with fibroid. Among them maximum 72.0% uterine fibroid were found at the age range between 25-35 years, majority (50.0%) being primi. The rate of spontaneous pregnancy loss in women with fibroid was 28.0%. Again the loss rate was higher in women with multiple fibroids 40.9%. We observed good assoication of uterine fibroid with first trimester bleeding 28.0%, premature delivery 14.0%, premature rupture of membranes (PROM) 20.0%, abruptio placentae 2.0% and breech presentation 8.0%. The rate of Caesarean delivery was higher 76.0% in patients with fibroid. The risk of intrauterine growth retardation (IUGR) 18.0 and congenital anomalies of the fetus were also high (6.0%). Most common effect of Pregnancy on fibroid is degeneration. Conclusion: Fibroids with pregnancy appear to increase likelihood of complications during pregnancy, labour and delivery. Key word: Uterine fibroid, Ultrasonogram, effect. 1. Gomple C. Pathology in Gynecology and obstetrics 2nd ed. Philadelphia, Lippincott 1977:184. 2. Rice JP, Kay HH, Mahony BS. The clinical significance of uterine leiomyomas in pregnancy. Am J Obstet Gynecol 1989; 160:1212-6. 3. Exacoustos C, rosati P. Ultrasound diagnosis of uterine myomas and complications in pregnancy. Obstet Gynecol 1993; 82:97-101. 4. Katz VL, Dotters DJ, Droegemueller W. Complications of uterine myomas and complications in pregnancy. Obstet Gynecol 1989; 73:593-6. 5. Burton CA, Grimes DA, March CM. Surgical management of leiomyomata during pregnancy. Obstet Gynecol 1989: 74:593-6. 6. Hasan F, Arumugam K, Sivanesaratnam V. Uterine leiomyomata in pregnancy. Int J Gynaecol Obstet 1991; 34-45-8. 7. Davis JL, Ray-Mazumder S, Hobel CJ, Baley K, Sassoon D. Uterine leiomyomas in pregnancy: A prospective study. Obstet Gynecol 1990; 75:41-4. 8. Rosati P, Exacoustos C, Mancuso S. Longitudinal evaluation of uterine myoma growth during pregnancy. J Ultrasound Med 1992; 11:511. 9. Vergani P, Ghidini A, Strobelt N, et al. Do uterine leiomyomas influence pregnancy outcome? Am J Perinatol 1994; 11:356. 10. Rice JP, Kay HH, Mahoney BS. The Clinical significance of uterine leiomyomas in pregnancy. Am J obstet Gynecol 1989; 160:1212. 11. Katz VL. Dotters DJ, Droegemueller W. Complications of uterine leiomyomas in pregnancy. Obstet Gynecol 1989; 73:593. 12. Muram D, Gillieson M, Walters JH. Myomas of the uterus in pregnancy: ultrasonographic follow-up. Am J Obstet Gynecol 1980; 138:16. 13. Davis JL, Ray-Mazumder S, Hobel CJ, et al. Uterine leiomyoms in pregnancy: a prospective study. Obstet Gynecol 1991; 75:41. 14. Phelan JP. Myomas and pregnancy, Obstet Gynecol Clin North Am 1995; 22:801. 15. Lev-Toaff AS Coleman BG, Arger Ph, et al. Leiomyomas in pregnancy: sonographic study. Radiology 1987; 164:375. 16. Exacoustos C, Rosati P, Ultrasound diagnosis of uterine myomas and complications in pregnancy. Obstet Gynecol 1993; 82:97. 17. Ghristine M, David A: uterine’ Leiomyomas in the infertile patients, Radiology, 1988, 167:627-630. 18. Carol B. Benson, Jeanne S. Chow, Wendy Chang-Lee, Jiseph A, Hill III, Peter M. Doubilet, Outcome a pregnancies in women with uterine lieomyomas Identified by Sonography in the First Trisesta. 2001; 29:45-9. 19. Benson CB, Doubilet PM, Cooney MJ, Early singleton pregnancy outcome: effects of maternal age and mode of conception. Radiology 1997:203:399. 20. Rosati P. Bellati U, Exacoustos C et al. Uterine myoma in pregnancy: ultrasound study. Int J Gynaecol Obstet 1989; 28:109. 21. American society for Reproductive Medicine, Bironighans, Alaboma. Fertility and sterility. Vol. 82, SUPPL. 1st September 2004. 22. Rice JP, Kay HH, Mahony BS. The clinical significance of uterine leiomyomas in pregnancy. Am J Obstet Gynecol 1989; 160:1212-6. 23. Muram D, Gillieson M, Walters JH. Myomas of the uterus in pregnancy: ultrasonographic follow-up. Am J Obstet Gynecol 1980; 138:16-9. 24. Lev-Toaff AS, Coleman BG, Arger PH, Mintz MC, Arenson RL, Toaff Me. Leiomyomas in pregnancy: sonographic study. Radiology 1987;164:375-80. 25. Gloria D, Coronado, LYNW, M. MARSHALL, Sed, AND Stephen M, Schwartz, Complications of pregnancy Labour and Delivery with literal, Leiomyomas: A population Based study 2002; 95:43-45.Abstract
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