FIBROIDS IN PREGNANCY;

Abstract

Objectives: The objective of this study was to determine the frequency ofcomplications in pregnant women with fibroids in 3rd trimester. Study design: Descriptive CaseSeries. Setting: Department of Obstetrics & Gynecology, Nishtar Hospital, Multan. Period: 15thDecember 2014 to 15th June 2015. Subjects & Methodology: Where sample size was calculatedusing WHO sample size calculator using expected proportion of intrauterine growth restrictionp= 4%.11 163 pregnant women of 20-40 year of age with uterine fibroid of ≥3cm on ultrasoundwere included in this study. Patients of endometriosis and hypertension were excluded. Anobstetrical ultrasonography was done to confirm singleton pregnancy, size of uterine fibroidand to confirm gestational age. Patients were monitored until delivery and complications wererecorded. Preterm labour was defined as dilation of the cervix <4cm with the presence ofuterine contractions of ≥ 4 per hour of 30 seconds duration with intensity to effect progressiveeffacement, assessed by vaginal examination. Malpresentation was defined as a presentationin which baby’s bottom or feet, instead of head, are in position relative to the maternal pelvis byultrasound and IUGR was defined as fetal weight below the 10th percentile and fetal abdominalcircumference below the 10th percentile on ultrasound. Results: Age range in this studywas from 20 to 40 years with mean age of 32.773±1.99 years, mean gestational age34.730±2.44 weeks, fibroid size 5.736±1.51cm, duration of complain 5.018±1.41 months,height 1.561±0.11 meters, mean weight 73.619±13.66 Kg and mean BMI was 28.607±3.106Kg/m2. Majority of the patients were from 31-40 year group (89%). Preterm labour was seenin 15.3% patients, malpresentation was 7.4% and IUGR was seen in 6.1% patients. Conclusion:Our study conclude that, most common complication of uterine fibroids during pregnancy waspreterm labour followed by malpresentation and IUGR.