Uterine fibroids: from pregnancy to neonatal outcomes

Abstract

To study the effects of uterine fibroids on obstetrical and neonatal outcomes. A retrospective cohort analysis. All department ultrasounds from 1998 to 2006 were reviewed. All patients diagnosed with fibroids at initial obstetrical ultrasound were included to total 152. A control group was extracted from the same database, in a 1:1 ratio. The following parameters were paired for the fibroid and control group: age, gravidity, parity and year of delivery. Obstetrical and neonatal outcomes were compared in the two groups using the Fisher's Exact and Pearson's Chi-square test for categorical variables and Mann-Whitney U test for non-normally distributed measures. A total of 317 pregnancies were included in the analysis, of which 152 women had uterine fibroids and 165 did not. Demographics were comparable in the two groups except the African American race which was significantly higher in the fibroid group (90.8 vs. 68.5%, P<.001). Co-morbidities were comparable, except chronic hypertension (13.8 vs. 6.7, P=.040). Fibroid degeneration occurred in 23% of the pregnancies. (Table1) compares the obstetrical and neonatal outcomes.Tabled 1Obstetrical and Neonatal outcomesOutcomeFibroidControlp valueFirst trimester loss (%)7.93.6.143Second trimester loss (%)5.91.2.029Preterm labor (%)16.42.4<.001PPROM∗Premature preterm rupture of membranes. (%)15.83.6<.001IUGRIntrauterine growth restriction (%)15.18.5.08Malpresentation (%)22.06.0<.001Cesarean (%)54.328.0<.001Low transverse Cesarean (%)74.795.3.005Classical cesarean (%)17.34.7.08Pre-eclampsia (%)11.83.1.003Estimated blood loss (cc)732.7 ± 578.93466.1 ± 366.04<.001Birth weight (grams)2634.8 ± 1052.463181.4 ± 628.15<.001Apgars at 1 and 5 minutes6.7 & 7.97.8 & 8.8<.001Gestational age at delivery (weeks)35.3 ± 6.738.6 ± 2.8<.001Delivery before 37 weeks (%)10.133.3<.001∗ Premature preterm rupture of membranes.∗∗ Intrauterine growth restriction Open table in a new tab Uterine fibroids complicate the pregnancy course as evidenced by a considerable impact on obstetrical and neonatal outcomes.