Uterine Leiomyoma Do Not Appear To Be a Risk Factor for Shortened Cervical Length [30L

Abstract

INTRODUCTION: Several studies report an increased incidence of preterm delivery (PTD) in patients with uterine leiomyoma (UL). A shortened cervical length (CL) is risk factor for PTD, although universal CL screening is not yet advocated nationally. CL studies in pregnancies complicated by UL have suffered from small sample size or lack of accurate CL measurements. Therefore it is not well known whether the risk of PTD in those women with UL can be appropriately screen utilizing CL. Therefore, we reviewed our data on transvaginal (TVS) CL in those patients with UL. METHODS: We performed a retrospective review of patients found to have UL on routine second trimester anatomic survey ultrasounds after establishing a CL screening program. Patient demographics, UL (number and size), TVS-CL and pregnancy outcomes were collected. RESULTS: We obtained data on 224 antepartum patients with UL. Mean age was 34.9 ± 4.9 y, and BMI 29.1 ± 6.6 kg/m2. Prior PTD was noted in 21/224 (9.3%). Multiple UL were noted in 67/224 (29.9 %) with an individual's largest UL diameter of 4.5 ± 2.6 cm. Screening occurred at 21 ± 3.2 wks. Mean TVS-CL was 3.9 ± 0.8 cm. Shortened cervix (less than 2.5 cm) occurred in 2/224 (0.9%). Delivery less than 37 weeks occurred in 38/224 (17%) and before 35 weeks in 18/224 (8%). The cesarean delivery was performed in 85/224 (37.9%). CONCLUSION: TVS-CL in pregnancies complicated by UL do not appear to be significantly shortened. However, the incidence of PTD in patients with UL remains increased compared to national rates.