Elsevier

Fertility and Sterility

Volume 97, Issue 1, January 2012, Pages 107-110
Fertility and Sterility

Original article
Adverse obstetric outcomes associated with sonographically identified large uterine fibroids

Preliminary data from this study were presented at the 66th Annual Meeting of the American Society for Reproductive Medicine, Denver, Colorado, October 23–27, 2010.
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Study Objective

To determine the impact of sonographically identified large uterine fibroids (>5 cm in diameter) on obstetric outcomes.

Design

Retrospective cohort study.

Setting

University teaching hospital.

Patient(s)

Women with singleton gestations (n = 95) noted to have uterine fibroids on obstetric ultrasonography from September 2009 through April 2010 and age-matched controls (n = 95).

Intervention(s)

None.

Main Outcome Measure(s)

Obstetric outcomes including short cervix, preterm premature rupture of membranes, and preterm delivery.

Result(s)

Compared to women with no fibroids or small fibroids (≤5 cm), women with large fibroids (>5 cm) delivered at a significantly earlier gestational age (38.6 vs. 38.4 vs. 36.5 weeks). Short cervix, preterm premature rupture of membranes, and preterm delivery were also significantly more frequent in the large fibroid group, and were associated with number of fibroids >5 cm in diameter. Blood loss at delivery was significantly higher in the large fibroid group (486.8 vs. 535.6 vs. 645.1 mL), as was need for postpartum blood transfusion (1.1 vs. 0.0 vs. 12.2%).

Conclusion(s)

Women with large uterine fibroids in pregnancy are at significantly increased risk for delivery at an earlier gestational age compared to women with small or no fibroids, as well as obstetric complications including excess blood loss and increased frequency of postpartum blood transfusion.

Key Words

Fibroid
leiomyoma
ultrasonography
pregnancy
short cervix
preterm delivery
premature rupture of membranes
blood transfusion

Cited by (0)

V.I.S. has nothing to disclose. M.T. has nothing to disclose. A.S. has nothing to disclose. M.L.K. has nothing to disclose. T.B.J. has nothing to disclose. M.S. has nothing to disclose. E.E.P. has nothing to disclose. M.P.D. is a grant recipient from NICHD, Bio Sante, Boehringer Ingelheim, and Interlace Medical, serves as a consultant to Genzyme, Omrix, EMD Serono, Neomend, Boehringer Ingelheim, Auxogyn, Halt Medical, ZSX Medical, and Sanofi Aventis, and owns stock in SyntheMed and Neomend.