Abstract
BackgroundOur objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy.MethodsWe analyzed the national health insurance database, which covers almost the entire Korean population, between 2004 and 2015. The risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma, were analyzed in multivariate logistic regression analysis.ResultsDuring the study period, 38,402 women with diagnosed myoma(s), 9890 women with a history of myomectomy, and 740,675 women without a diagnosed myoma gave birth. Women with a history of diagnosed myoma(s) and women with a history of myomectomy had significantly higher risks of cesarean section (aOR 1.13, 95% CI 1.1–1.16 and aOR 7.46, 95% CI 6.97–7.98, respectively) and placenta previa (aOR 1.41, 95% CI 1.29–1.54 and aOR 1.58, 95% CI 1.35–1.83, respectively), compared to women without a diagnosed myoma. And the risk of uterine rupture was significantly higher in women with previous myomectomy (aOR 12.78, 95% CI 6.5–25.13), compared to women without a diagnosed myoma, which was much increased (aOR 41.35, 95% CI 16.18–105.69) in nulliparous women. The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy.ConclusionsWomen with a history of myomectomy had significantly higher risks of cesarean section and placenta previa compared to women without a diagnosed myoma.
Highlights
Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy
Surgical interventions such as myomectomy have been tried in infertile women without specific causes, it is unclear whether the treatment of uterine fibroids can improve pregnancy outcomes, except for cavity-distorting myomas [4]
Multivariate logistic regression analysis was used to estimate the adjusted odd ratio and the 95% confidence interval (CI) s for the Results From 2014 to 2015, 789,482 women delivered in Korea
Summary
Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy. It has been reported that the presence of fibroids is associated with infertility, spontaneous abortion, fetal malpresentation, placenta previa, preterm birth, cesarean section, and peripartum hemorrhage [3] Surgical interventions such as myomectomy have been tried in infertile women without specific causes, it is unclear whether the treatment of uterine fibroids can improve pregnancy outcomes, except for cavity-distorting myomas (submucosal, or intramural with a submucosal component) [4]. In Korea, the number of women who underwent myomectomy have increased 37.3% between 2006 and 2010 [8] Women in their 30s and 40s, who are a major population for pregnancy, have been major candidates for myomectomy, there have been poor evidences about obstetric outcomes in women with myoma and previous myomectomy [9]
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