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. 2022 Jul 22;23(15):8064.
doi: 10.3390/ijms23158064.

Uterine Fibroids Causing Preterm Birth: A New Pathophysiological Hypothesis on the Role of Fibroid Necrosis and Inflammation

Emma E Don  1   2 , Anadeijda J E M C Landman  1   2 , Guus Vissers  1 , Ekaterina S Jordanova  3   4 , Emiel D Post Uiterweer  5   6 , Christianne J M de Groot  1   2 , Marjon A de Boer  1   2 , Judith A F Huirne  1   2
Affiliations

Uterine Fibroids Causing Preterm Birth: A New Pathophysiological Hypothesis on the Role of Fibroid Necrosis and Inflammation

Emma E Don et al. Int J Mol Sci. .

Abstract

According to recent studies and observations in clinical practice, uterine fibroids increase the risk of preterm birth. There are several theories on the pathogenesis of preterm birth in the presence of fibroids. One theory proclaims that fibroid necrosis leads to preterm birth, though pathophysiological mechanisms have not been described. Necrotic tissue secretes specific cytokines and proteins and we suggest these to be comparable to the inflammatory response leading to spontaneous preterm birth. We hypothesize that fibroid necrosis could induce preterm parturition through a similar inflammatory response. This new hypothesis generates novel perspectives for future research and the development of preventative strategies for preterm birth. Moreover, we emphasize the importance of the recognition of fibroids and especially fibroid necrosis by clinicians during pregnancy.

Keywords: degeneration; inflammation; necrosis; pregnancy; premature labor; preterm birth; uterine fibroid.

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Conflict of interest statement

The authors declare that they have no conflict of interest. J.A.F.H. discloses received grants to the institution for other projects from NWO (Dutch research organization), Samsung, and Plantec Medical for research on imaging of uterine disorders and on adhesion barrier during surgery, respectively.

Figures

Figure 1
Figure 1
Fibroid necrosis during pregnancy. Schematic representation of the hypothesized inflammatory pathway of necrosis and induction of pre-term labor in women with fibroid necrosis during pregnancy.
See this image and copyright information in PMC

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