Pregnancy with Fibroids and Its Obstetric Complications
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 3
Abstract
Abstract: Women with uterine fibroids are more likely have pregnancies complicated by fetal malpresentation, preterm birth, and preterm premature rupture of membranes (PPROM), placenta previa, placental abruption, cesarean delivery, and severe postpartum hemorrhage. Objective of this study was to assess the prevalence and obstetric complications of fibroids during pregnancy. This cross-sectional study was carried out in Department of Obstetrics & Gynecology, Sri Aurobindo Medical College& Post Graduate Institute Hospital, Indore (M.P). Data of all patients who presented with fibroid during pregnancy during oneyears i.e., from Sept 2015 to Sept 2016 was recorded on a proforma. Thirty-two patients were diagnosed to have fibroids during pregnancy out of 2400 deliveries, thus prevalence was 1.33% in our hospital. Fibroids were found less common in patients in their first pregnancy (8, 25%). Twenty-three (71.87%) patients were delivered by caesarean section, and in one (3.12%) patient hysterectomy was performed. Failure to progress and fetal distress was the commonest indication for caesarean section (10, 43.47%) followed by breech presentation (4, 17.39%), cord prolapse (1, 3.12%) and fibroids in the lower segment (3, 13.04%). Anemia was the commonest complication (12, 40.62%) followed by postpartum haemorrhage (PPH) (7, 21.87%). Premature rupture of membranes and cord prolapse was seen in 1(3.12%) patients each. Two (6.25%) patients underwent abdominal hysterectomy. Intra uterine growth restriction IUGR was seen in 1 patient (3.12%), 2 patients ended up with abortions, 1 patient had a spontaneous pregnancy loss and the other underwent hysterectomy due to low lying placenta and heavy bleeding per vaginum. Compound presentation, neglected transverse lie, assisted vaginal breech delivery, placenta increta, retained placenta, low lying placenta, were the other complications occurring in one patient each. No mortality was seen. Neonatal outcome was encouraging as 19 (59.37%) babies were of average birth weight and only 2 (6.25%) babies had low APGAR score and needed NICU admission. Perinatal mortality was 37/1000 live births. Fibroids during pregnancy are known to adversely affect its outcome. There is an increased risk of abortion or miscarriage, preterm labour, abnormal presentation, accidental hemorrhage, dystociclabour, post-partum haemorrhage (PPH), puerperal sepsis and uterine inversion. Fibroids situated in the body of the uterus usually become displaced upwards. Pregnancy with fibroids leads to increase in caesarean section rate due to dysfunctional labour and malpresentation. Keywords:Fibroid, leiomyoma, pregnancy
Authors and Affiliations
Madhuri Alwani, Ravjyot Kaur, Shruti Pathak, Ratna Thakur
Keywords
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