Outcome of Pregnancies Associated with Fibroids

Abstract

Objectives: To evaluate the behaviour of uterine leiomyoma, their frequency and impact on the course of pregnancy Design: It was a descriptive study. Setting: Gynaecology and Obstetric Unit, Hayatabad Medical Complex, PGMI, Peshawar. Subjects: All the patients presenting to antenatal clinic or emergency having a pregnancy associated with fibroids from 1st July 2001 to 30th June 2002. Subject and Methods: Women diagnosed with leiomyoma during pregnancy were evaluated clinically and the findings were confirmed by ultrasound. Detection of leiomyoma during caesarean section also made the patient eligible for the study. In all there were 76 patients in the study. The size of leiomyoma, the type of leiomyoma, their effect on pregnancy outcome and complications were noted. Patients obstetric, and fertility history was recorded on a questionnaire. The concerned doctors were required to fill a performa regarding the outcome and complications the delivery of such patients. Data Analysis: After data collection, the data was analyzed using various statistical tests like percentage, relative risk (R.R), ods ratio (O.R), mean, standard deviation (S.D) confidence interval (C.I), using software SPSS version 8.0 and Epi-Info 6. Main Outcome Measures: The main outcome measures were noted down as the frequency of spontaneous pregnancy loss, vaginal delivery or the caesarean section. Results: Out of 76 patients (1.9%), 16 underwent spontaneous pregnancy loss (21 %, O.R 1.16. R.R 1.13, P 0.59), 31 had vaginal delivery (40.8%, O.R 0.21, R.R 0.62, P 0.0000) and 29 had caesarean section (38.2%. O.R 4.71, R.R 2.91, P 0.0000). The frequency of complicated deliveries was 73.3%. The different complications occurring were antepartum haemorrhage, acute abdomen, laparotomy, preterm labour, dysfunctional labour, retained placenta and retained products of conception. Conclusion: Although abortions, preterm delivery, dysfunctional labour and cesarean sections were common, the neonatal outcome in viable pregnancies was fairly good in women with uterine leiomyomas. Because of increased risk of complications all the patients with leiomyomas having pregnancy should be considered as high-risk cases.