A study of maternal and fetal outcome in fibroid complicating pregnancy

Abstract

Introduction: Leiomyomas are the most common benign smooth muscle tumours of the uterus in the reproductive age group. Incidence of fibroid in pregnancy is between 1-2% (1). Risk of complications increase with increase in the size of fibroid. Aim: The aim of our study was to evaluate the incidence, maternal and fetal outcomes in pregnancies complicated with fibroids. The present study was conducted in the Department of OBG, NRI medical college, Chinakakani, a tertiary care hospital, Andhra Pradesh. Materials and methods: This was a retrospective observational study conducted over a period of 4 years i.e., January 2017 to Aug 2020. Total 50 pregnant women with fibroid >3cm were included in the study. Maternal age, parity, gestational age, past history of myomectomy, complications during pregnancy, mode of delivery and caesarean myomectomy were the criteria noted. Results: The incidence of fibroid complicating pregnancies in our study was 0.78%. Majority of women were multigravidae (66%) and belong to the age group 31 to 35 (38%). Most of the cases were diagnosed in 1st trimester and only 12% of cases had previous history of myomectomy. Though asymptomatic cases form a major group, maternal complications include abortion (4%), APH(6%), pain abdomen (12%), PROM and preterm labour (10%), PPH (20%). Fetal complications include FGR (12%), LBW (12%). Caesarean section was the most common mode of delivery (58%). Caesarean myomectomy was done in only 17.8% of the women. Conclusion: Majority of fibroids during pregnancy were asymptomatic, increased risk was seen with increase in size of fibroids. Prompt ante-partum, intrapartum and post-partum surveillance and management helps in combating these complications. Myomectomy in selected cases results in better obstetric outcome.