Advertisement

The clinical significance of uterine leiomyomas in pregnancy

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      In a retrospective review of 6706 pregnancies between 1981 and 1985, uterine leiomyomas were documented by antenatal sonography in 93 (1:4%) patients. The obstetric records and sonograms of patients with documented leiomyomas were reviewed and compared with fiata from matched control patients managed at our institution during the same time period. Among the 93 patients with leiomyomas, 14 (15.1 %) had one or more leiomyomas subjacent to the maternal surface of.the placenta. Significantly, eight of 14 (57%) of these patients with retroplacental leiomyomas subsequently developed abruptio placentae, which resulted in the deaths of, four fetuses. Conversely, among the remaining 79 patients whose leiomyomas were not retroplacental, abruptio. placentae occurred in only two patients (2.5%), neither of which resulted in fetal death. Clinically significant pain requiring narcotic analgesia developed in 14 of 93 (15.1%) patients and premature labor occurred in 20 of 93 (21.5%); pain and premature labor correlated positively with the size of the largest myoma. Delivery by cesarean section and. vacuum assistance occurred significantly more frequently in patients with leiomyomas than in those without documented leiomyomas. In this population uterine myomas did not significantly alter the incidence of intrauterine growth retardation and low Apgar scores. (Am J Obstet Gynecol 1989;160:1212-6.)

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Roberts JA
        Management of gynecologic tumors during pregnancy.
        Clin Perinatol. 1983; 10: 369
        • Parks J
        • Barter RH
        The myomatous uterus complicated by pregnancy.
        Am J Obstet Gynecol. 1952; 63: 260
        • Gainey HL
        • Keeler JF
        Submucous myoma in term pregnancy.
        Am J Obstet Gynecol. 1949; 58: 727
        • Gross BH
        • Silva TM
        • Jaffe MH
        Sonographic features of uterine leiomyoma: analysis of 41 proven cases.
        J Ultrasound Med. 1983; 2: 401
        • Muram D
        • Gillieson M
        • Walters JH
        Myomas of the uterus in pregnancy: ultrasonic follow-up.
        Am J Obstet Gynecol. 1980; 138: 16
        • Winer-Muram HT
        • Muram D
        • Gillieson MS
        • et al.
        Uterine myomas in pregnancy..
        J Can Assoc Radiol. 1984; 35: 168
        • Kosmak MD
        Fibroid tumors complicating pregnancy and their treatment.
        Am J Obstet Gynecol. 1923; 6: 63
        • Watson BP
        Pregnancy and labor complicated by fibroid tumors.
        Am J Obstet Gynecol. 1932; 23: 351
        • Gainey HL
        • Keeler JE
        Submucous myoma in term pregnancy.
        Am J Obstet Gynecol. 1949; 58: 727
        • Blum M
        Comparative study of serum CAP activity during pregnancy in malformed and normal uterus.
        J Perinatol Med. 1978; 6: 165
        • Pritchard JA
        • MacDonald PC
        Williams' obstetrics. Appleton-Century-Crofts, New York1980: 495-496
        • Pritchard J
        • Mason R
        • Corley M
        • et al.
        Genesis of severe placental abruption.
        Am J Obstet Gynecol. 1970; 108: 22
        • Hertig AT
        Symposium on obstetrics..
        Clinics. 1945; 4: 585
        • Frossman L
        Distribution of blood flow in myomatous uteri as measured by locally-injected xenon.
        Acta Obstet GynecolScand. 1976; 55: 101
        • Persaud V
        • Arjoon PD
        Uterine leiomyomas: incidence of degenerative change and a correlation of associated symptoms.
        Obstet Gynecol. 1970; 35: 432