The impact of fibroid characteristics on pregnancy outcome

Lam, Sarah-Jane, Best, Sunayna and Kumar, Sailesh (2014) The impact of fibroid characteristics on pregnancy outcome. American Journal of Obstetrics and Gynecology, 211 4: 395.e1-395.e5. doi:10.1016/j.ajog.2014.03.066

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Author Lam, Sarah-Jane
Best, Sunayna
Kumar, Sailesh
Title The impact of fibroid characteristics on pregnancy outcome
Journal name American Journal of Obstetrics and Gynecology   Check publisher's open access policy
ISSN 0002-9378
1097-6868
Publication date 2014-10
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.ajog.2014.03.066
Open Access Status
Volume 211
Issue 4
Start page 395.e1
End page 395.e5
Total pages 5
Place of publication Philadelphia, United States
Publisher Mosby
Collection year 2015
Language eng
Formatted abstract
Objective

The objective of the study was to assess the influence of different characteristics of fibroids on pregnancy outcome.

Study Design

We identified women with fibroids 4 cm or greater in size on ultrasonography at the dating scan between January 2002 and December 2012. The size (4-7 cm, 7-10 cm, >10 cm), number (multiple/single), location (lower uterus/body of uterus), and type (intramural, combination of intramural/subserosal, subserosal) were ascertained. Medical records were reviewed to obtain pregnancy outcomes (preterm delivery, birthweight, mode of delivery, estimated blood loss, postpartum hemorrhage, and admission for fibroid-related pain).

Results

A total of 121 patients with 179 pregnancies were identified. Preterm delivery was more likely in those with multiple fibroids compared with single fibroids (18% vs 6%; P = .05). The location of the fibroid had an important effect on the mode of delivery with a higher cesarean section rate for fibroids in the lower part of uterus than in the body of the uterus (86% vs 40%; P = .01), a higher rate of postpartum hemorrhage (22% vs 11%; P = .03), and greater estimated blood loss (830 mL [SD, 551] vs 573 mL [SD, 383]; P = .03). Increasing size of fibroid was associated with greater rates of hemorrhage (11% vs 13% vs 36%; P = .04), increased estimated blood loss (567 mL [SD, 365] vs 643 mL [SD, 365] vs 961 mL [SD, 764]; P = .01), and higher rates of admissions for fibroid-related pain (5% vs 23% vs 21%; P = .01).

Conclusion

Different fibroid characteristics affect pregnancy outcome in varying ways. This information can be used to aid counseling women antenatally and in risk-stratifying patients.
Keyword Fibroid
Leiomyoma
Pregnancy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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