Abstract
To evaluate the obstetric outcomes of singleton high-risk pregnancies with a small size uterine fibroid. This retrospective cohort study was conducted among 172 high-risk pregnant women who were followed-up by a single surgeon between 2016 and 2019. Pregnant women with preconceptionally diagnosed small size (< 5 cm) single uterine fibroids (n = 25) were compared with pregnant women without uterine fibroids (n = 147) in terms of obstetric outcomes. There was no statistically significant difference between the groups in terms of adverse pregnancy outcomes. The size of the fibroids was increased in 60% of the cases, and the growth percentage of the fibroids was 25% during pregnancy. Intrapartum and short-term complication was not observed in women who underwent cesarean myomectomy. Small size uterine fibroids seem to have no adverse effect on pregnancy outcomes even in high-risk pregnancies, and cesarean myomectomy may be safely performed in properly selected cases.
Highlights
Uterine fibroids are benign monoclonal smooth muscle neoplasms and are the most common pelvic tumors in women of reproductive age
The size of the fibroids was increased in 60% of the cases, and the growth percentage of the fibroids was 25% during pregnancy
Intrapartum and short-term complication was not observed in women who underwent cesarean myomectomy
Summary
Uterine fibroids ( known as myomas) are benign monoclonal smooth muscle neoplasms and are the most common pelvic tumors in women of reproductive age. The most common complications of fibroids during pregnancy are pain due to degeneration or torsion of the pedunculated fibroid, as well as pelvic pressure-related problems and vaginal bleeding.. The frequency of major adverse outcomes correlates with the size of the fibroid and is especially high in women with fibroids > 5 cm in diameter.. The majority of prospective studies using ultrasound to follow the size of uterine fibroids during pregnancy have shown that fibroid size remains stable (< 10% change in size) from the pregestational period to the end of pregnancy.. The incidence of fibroids in pregnancy is from 3.3 to 10.7%.1,2 most pregnancies in women with fibroids are uneventful, adverse pregnancy outcomes due to fibroids, such as miscarriage, preterm labor, placenta previa, placental abruption, fetal growth restriction, malpresentation, and peripartum hemorrhage, may occur in 10 to 30% of these patients. the most common complications of fibroids during pregnancy are pain due to degeneration or torsion of the pedunculated fibroid, as well as pelvic pressure-related problems and vaginal bleeding. The frequency of major adverse outcomes correlates with the size of the fibroid and is especially high in women with fibroids > 5 cm in diameter.
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