open access

Vol 90, No 6 (2019)
Research paper
Published online: 2019-06-28
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Symptomatic uterine fibroids in pregnancy — wait or operate? Own experience

Anna Fuchs1, Agnieszka Dulska1, Jerzy Sikora1, Iwona Czech1, Violetta Skrzypulec-Plinta2, Agnieszka Drosdzol-Cop1
·
Pubmed: 31276183
·
Ginekol Pol 2019;90(6):320-324.
Affiliations
  1. Department of Pregnancy Pathology, Department of Woman’s Health, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
  2. Department of Woman’s Health, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland

open access

Vol 90, No 6 (2019)
ORIGINAL PAPERS Gynecology
Published online: 2019-06-28

Abstract

Objectives: Uterine fibroids are one of the most common benign tumors of the female genital tract. The major complication of myomas in pregnancy is a recurrent pain, however the misscariage is the main threat. The negative impact of myomas on the course of pregnancy may also result in i.e. uterine bleeding, higher incidence of a maternal-fetal incommunicability, an incorrect position of the fetus and its deformities. 

Material and methods: The patient aged 31 was admitted to Mother and Child Health Center in Zabrze due to the threatened miscarriage. The primigravid at 19 weeks’ gestation was previously diagnosed with myoma. On admission the ultrasonography revealed one alive fetus in the uterus and a nodular change on the right side of the uterine fundus, 13 x 11 cm in size and non-homogenous echo. 

Results: The patient was qualified to the conservative myomectomy. 11 days after the enucleation of 25 cm in diameter myoma, patient in good condition, with the maintained, alive foetus was discharged from the hospital. Patient at 34 weeks’ gestation was re-admitted due to the beginning of uterine contraction. After one week of observation within the ward, with tocolytic drugs and steroids administered, at 35th week of pregnancy the patient gave birth to a live daughter via the Ceasarian section. 

Conclusions: Prenatal myomectomy can be safely performed in the first and second trimester of pregnancy, however it is recommended to deliver the baby via Caesarean section, due to fear of intrauterine rupture of the uterus. 

Abstract

Objectives: Uterine fibroids are one of the most common benign tumors of the female genital tract. The major complication of myomas in pregnancy is a recurrent pain, however the misscariage is the main threat. The negative impact of myomas on the course of pregnancy may also result in i.e. uterine bleeding, higher incidence of a maternal-fetal incommunicability, an incorrect position of the fetus and its deformities. 

Material and methods: The patient aged 31 was admitted to Mother and Child Health Center in Zabrze due to the threatened miscarriage. The primigravid at 19 weeks’ gestation was previously diagnosed with myoma. On admission the ultrasonography revealed one alive fetus in the uterus and a nodular change on the right side of the uterine fundus, 13 x 11 cm in size and non-homogenous echo. 

Results: The patient was qualified to the conservative myomectomy. 11 days after the enucleation of 25 cm in diameter myoma, patient in good condition, with the maintained, alive foetus was discharged from the hospital. Patient at 34 weeks’ gestation was re-admitted due to the beginning of uterine contraction. After one week of observation within the ward, with tocolytic drugs and steroids administered, at 35th week of pregnancy the patient gave birth to a live daughter via the Ceasarian section. 

Conclusions: Prenatal myomectomy can be safely performed in the first and second trimester of pregnancy, however it is recommended to deliver the baby via Caesarean section, due to fear of intrauterine rupture of the uterus. 

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Keywords

uterine fibroids; prenatal myomectomy; pregnancy complications

About this article
Title

Symptomatic uterine fibroids in pregnancy — wait or operate? Own experience

Journal

Ginekologia Polska

Issue

Vol 90, No 6 (2019)

Article type

Research paper

Pages

320-324

Published online

2019-06-28

Page views

3001

Article views/downloads

1941

DOI

10.5603/GP.2019.0058

Pubmed

31276183

Bibliographic record

Ginekol Pol 2019;90(6):320-324.

Keywords

uterine fibroids
prenatal myomectomy
pregnancy complications

Authors

Anna Fuchs
Agnieszka Dulska
Jerzy Sikora
Iwona Czech
Violetta Skrzypulec-Plinta
Agnieszka Drosdzol-Cop

References (18)
  1. Casini ML, Rossi F, Agostini R, et al. Effects of the position of fibroids on fertility. Gynecol Endocrinol. 2006; 22(2): 106–109.
  2. Klatsky PC, Tran ND, Caughey AB, et al. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstet Gynecol. 2008; 198(4): 357–366.
  3. Neiger R, Sonek JD, Croom CS, et al. Pregnancy-related changes in the size of uterine leiomyomas. J Reprod Med. 2006; 51(9): 671–674.
  4. Flake GP, Andersen J, Dixon D. Etiology and pathogenesis of uterine leiomyomas: a review. Environ Health Perspect. 2003; 111(8): 1037–1054.
  5. Coronado GD, Marshall LM, Schwartz SM. Complications in pregnancy, labor, and delivery with uterine leiomyomas: a population-based study. Obstet Gynecol. 2000; 95(5): 764–769.
  6. Egbe TO, Badjang TG, Tchounzou R, et al. Uterine fibroids in pregnancy: prevalence, clinical presentation, associated factors and outcomes at the Limbe and Buea Regional Hospitals, Cameroon: a cross-sectional study. BMC Res Notes. 2018; 11(1): 889.
  7. Vlahos NF, Theodoridis TD, Partsinevelos GA. Myomas and Adenomyosis: Impact on Reproductive Outcome. Biomed Res Int. 2017; 2017: 5926470.
  8. Awoleke JO. Myomectomy during Caesarean Birth in Fibroid-Endemic, Low-Resource Settings. Obstet Gynecol Int. 2013; 2013: 520834.
  9. Lee HJ, Norwitz ER, Shaw J. Contemporary management of fibroids in pregnancy. Rev Obstet Gynecol. 2010; 3(1): 20–27.
  10. Rosati P, Exacoustòs C, Mancuso S. Longitudinal evaluation of uterine myoma growth during pregnancy. A sonographic study. J Ultrasound Med. 1992; 11(10): 511–515.
  11. Celik C, Acar A, Ciçek N, et al. Can myomectomy be performed during pregnancy? Gynecol Obstet Invest. 2002; 53(2): 79–83.
  12. De Carolis S, Fatigante G, Ferrazzani S, et al. Uterine myomectomy in pregnant women. Fetal Diagn Ther. 2001; 16(2): 116–119.
  13. Rothmund R, Taran FA, Boeer B, et al. Surgical and Conservative Management of Symptomatic Leiomyomas during Pregnancy: a Retrospective Pilot Study. Geburtshilfe Frauenheilkd. 2013; 73(4): 330–334.
  14. Kumar R R, Patil M, Sa S. The utility of caesarean myomectomy as a safe procedure: a retrospective analysis of 21 cases with review of literature. J Clin Diagn Res. 2014; 8(9): OC05–OC08.
  15. Brown D, Fletcher HM, Myrie MO, et al. Caesarean myomectomy--a safe procedure. A retrospective case controlled study. J Obstet Gynaecol. 1999; 19(2): 139–141.
  16. Kwawukume EY. Caesarean myomectomy. Afr J Reprod Health. 2002; 6(3): 38–43.
  17. Dao D, Kang SJ, Midia M. The utility of apparent diffusion coefficients for predicting treatment response to uterine arterial embolization for uterine leiomyomas: a systematic review and meta-analysis. Diagn Interv Radiol. 2019; 25(2): 157–165.
  18. Pron G, Mocarski E, Bennett J, et al. Ontario UFE Collaborative Group. Pregnancy after uterine artery embolization for leiomyomata: the Ontario multicenter trial. Obstet Gynecol. 2005; 105(1): 67–76.

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