Leiomyomas in Pregnancy - Clinical Implications

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Dr. Mandira Dasgupta
Dr. Priyanka Angelina Xess
Dr. Urmi Sanyal
Dr. Partha Sarathi Mitra
Dr. Prabodh S Soreng
Dr. Sudhir Adhikari
Dr. Tapan Kumar Naskar

Abstract

Abstract

Objective: To assess the effect of pregnancy on leiomyomas, effect of leiomyomas on pregnancy, the maternal morbidity and mortality and the perinatal outcome in pregnancies associated with leiomyoma.

Materials and Methods: This prospective clinical study was conducted at Department of Obstetric and Gynecology, Medical College and Hospital, Kolkata from July 2012 to June 2013 on 40 pregnant women diagnosed with uterine leiomyoma.

Results: Out of the total number of 40 cases, 87.5% were more than 25 years of age. Diagnosis was by antenatal ultrasound in 87.5%. Location of leiomyoma was subserous in 60%. They were 10-50cc in size in 50%of cases, single in 77.5%, 3 or more in number in only 15%. In pregnancy, size remained unaltered in 60%, 20% increased in size and 10% showed a decrease in size. At the end of puerperium they disappeared or decreased in size in 87.5% of cases. Complications developed in 35% of cases out of which 12.5% had complete abortions, 5.7% had placental abruption, 5.7% had premature rupture of membrane and 8.6% had preterm labour. Vaginal delivery occurred in 22.5%, 65% underwent LSCD. The major (26.9%) indication was malpresentation, 11.5% for myoma >30cc and 7.7% for leiomyoma in lower uterine segment. Caesarean myomectomy was possible in 50% patients. 5.7% of newborns had an APGAR score <7 at 1 min, all had an APGAR score >7 at 5 mins. Low birth weight babies were 22.9%.

Conclusion: The course of leiomyoma in pregnancy is unpredictable, but complications may be avoided by repeated follow-up and a good pregnancy outcome can be achieved.

Keywords: Uterine Leiomyoma, Pregnancy, Threatened Abortion.

Published Oct 22, 2016

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