Ultrasound diagnosis of uterine myomas and complications in pregnancy
- PMID: 8515934
Ultrasound diagnosis of uterine myomas and complications in pregnancy
Abstract
Objective: To evaluate myomas for ultrasound-documented size, location, position, and relation to the placenta, and to relate these findings to complications during pregnancy, at delivery, and in the puerperium.
Methods: Among 12,708 pregnant patients who had ultrasound scans, 492 had uterine myomas. Single myomas were found in 88% of cases and multiple myomas in 12%. The myomas were evaluated for size, number, position, location, relationship to the placenta, and echogenic structure, and the outcome of pregnancy was compared to that of patients in the control group.
Results: A statistically significant increased incidence of threatened abortion, threatened preterm delivery, abruptio placentae, and pelvic pain was observed in patients with uterine myomas (P < .001). Abruptio placentae was particularly evident in women with myoma volumes greater than 200 cm3, submucosal location, or superimposition of the placenta. Pelvic pain was related to myoma volume greater than 200 cm3 and ultrasound findings of heterogeneous echo patterns and cystic areas. Mode of delivery, abortion, preterm birth, premature rupture of membranes, and fetal growth did not seem to be affected by the presence of myomas. Thirty-two women with uterine myomas were managed surgically. Thirteen underwent myomectomy during pregnancy. Of these, eight delivered at term and five delivered preterm after the 32nd week of gestation. None of the deliveries were associated with neonatal death. The other 19 patients had surgery at delivery. Nine myomectomies were performed at cesarean delivery. Of these, three were complicated by severe hemorrhage necessitating hysterectomy. Another nine hysterectomies were performed during cesarean and one after vaginal delivery.
Conclusions: In addition to myoma size, the ultrasound evaluation of pregnant women with myomas should include position, location, relationship to the placenta, and echogenic structure. These ultrasound findings make it possible to identify women at risk for myoma-related complications and could be useful in managing the pregnancy.
Comment in
-
Ultrasound diagnosis of uterine myomas and complications in pregnancy.Obstet Gynecol. 1993 Nov;82(5):881-2. Obstet Gynecol. 1993. PMID: 8414345 No abstract available.
Similar articles
-
Do uterine leiomyomas influence pregnancy outcome?Am J Perinatol. 1994 Sep;11(5):356-8. doi: 10.1055/s-2007-994554. Am J Perinatol. 1994. PMID: 7993518
-
[Significance of myoma-induced complications in pregnancy. A comparative analysis of pregnancy course with and without myoma involvement].Z Geburtshilfe Neonatol. 1998 Jul-Aug;202(4):154-8. Z Geburtshilfe Neonatol. 1998. PMID: 9783373 German.
-
Are ultrasonographic myoma characteristics associated with blood loss at delivery?Ultrasound Obstet Gynecol. 2009 Sep;34(3):322-5. doi: 10.1002/uog.7319. Ultrasound Obstet Gynecol. 2009. PMID: 19670350
-
Three-Dimensional-Printed Uterine Model for Surgical Planning of a Cesarean Delivery Complicated by Multiple Myomas.Obstet Gynecol. 2019 Apr;133(4):720-724. doi: 10.1097/AOG.0000000000003107. Obstet Gynecol. 2019. PMID: 30870296 Review.
-
Myomas and pregnancy.Obstet Gynecol Clin North Am. 1995 Dec;22(4):801-5. Obstet Gynecol Clin North Am. 1995. PMID: 8786883 Review.
Cited by
-
Contemporary management of fibroids in pregnancy.Rev Obstet Gynecol. 2010 Winter;3(1):20-7. Rev Obstet Gynecol. 2010. PMID: 20508779 Free PMC article.
-
Preterm Deliveries in Women with Uterine Myomas: The Japan Environment and Children's Study.Int J Environ Res Public Health. 2021 Feb 24;18(5):2246. doi: 10.3390/ijerph18052246. Int J Environ Res Public Health. 2021. PMID: 33668326 Free PMC article.
-
The Relationship between Total Fibroid Burden and First Trimester Bleeding and Pain.Paediatr Perinat Epidemiol. 2016 Mar;30(2):115-23. doi: 10.1111/ppe.12256. Epub 2015 Nov 3. Paediatr Perinat Epidemiol. 2016. PMID: 26525634 Free PMC article.
-
Leiomyomas in Pregnancy and Spontaneous Abortion: A Systematic Review and Meta-analysis.Obstet Gynecol. 2017 Nov;130(5):1065-1072. doi: 10.1097/AOG.0000000000002313. Obstet Gynecol. 2017. PMID: 29016496 Free PMC article.
-
Fibroid tumors are not a risk factor for adverse outcomes in twin pregnancies.Am J Obstet Gynecol. 2013 Jan;208(1):68.e1-5. doi: 10.1016/j.ajog.2012.10.879. Epub 2012 Oct 24. Am J Obstet Gynecol. 2013. PMID: 23103343 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical