A Prospective study to evaluate the feto-maternal outcome in pregnancy complicated by fibroid uterus
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 5732-5737
AbstractAim: The aim of the present study was to determine the maternal and fetal outcome in pregnancy complicated by fibroid uterus.
Material and methods: A prospective study was conducted in the Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar, India,for 1 year. Total 50 women admitted with the diagnosis fibroid with pregnancy. During our study period, the total number of deliveries was 1220, and a total number of antenatal outpatients were 150 Ultrasonogram done at booking visit and patients with fibroid of 5 cm and above were included in the study.
Results: We included 50 women who were having pregnancy with fibroids. A major proportion was in the younger age group of 25-35 years. The mean age in our study population is 28.5 years. Fibroids were more frequent in multigravidae 38 (76%), and primigravidae were 12(24%). 15 (30%) women were asymptomatic during pregnancy. Out of 50 women, 15 (30) were known the case of fibroid became pregnant, remaining 35 (70%) were diagnosed as having fibroid during routine antenatal visits. 12 women (24%) had pain, 6 of them (12%) had threatened preterm labor, 6(12%) had spontaneous miscarriage, and 3 (6%) had anemia, and placenta previa was diagnosed in 5 patients (10%). 44 women (88%) were crossed 37 completed weeks of gestation. Out of 44, 12(27.27%) women had a vaginal delivery, outlet forceps applied in 2 women (4.5%), and Vento use applied in one woman (4.5%). Lower segment cesarean section (LSCS) done in 27 women (61.36%), and cesarean hysterectomy proceeded in one woman (2.27%). Indications for LSCS were breech presentation in 3 (10.71%) women, 3 women were with post-cesarean pregnancy (10.71%) transverse lie in 5 (17.85%), placenta previa in 5 (17.85), premature rupture of membranes (PROM) with poor bishops score in 3 (10.71%), uterine inertia in 5 (17.85%), and non-progressive labor in 5 (17.85%). 9(20.45%) had PPH and myomectomy done in 5 (11.36%) patients. All 44 babies were with weight above 2.5 kg with good Apgar score. There was no perinatal and maternal mortality in our study.
Conclusion: Pregnancies with fibroids are associated with complications during antepartum, intrapartum, and PP period. They need frequent follow-up and evaluation. Most of the fibroids are asymptomatic, but may adversely affect the course of pregnancy and labor depending on their location and size. These pregnancies are associated with increased incidence of cesarean delivery and PPH and considered as high risk.
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