Maternal and Perinatal Outcomes of Pregnancies with Uterine Leiomyomas

Authors

DOI:

https://doi.org/10.21613/GORM.2022.1333

Keywords:

Leiomyomas, Maternal outcome, Myomectomy, Pregnancy, Perinatal outcome 

Abstract

OBJECTIVE: We aimed to determine the effect of uterine leiomyoma characteristics and cesarean myomectomy on maternal and perinatal outcomes.

STUDY DESIGN: The study included patients with singleton pregnancies and uterine leiomyomas who had delivered at or beyond 24 weeks' gestation; without comorbidities, uterine anomalies, or fetal malformations. Data from 240 patients were studied between 2012 and 2022 in the perinatology clinic of a tertiary care center. Maternal and perinatal outcomes were obtained from medical records.

RESULTS: Among the women with uterine leiomyomas, 21.7% were delivered vaginally and 78.3% via cesarean section. Myomectomy was performed in 150 out of 188 (79.8%) patients undergoing cesarean section. It was found that cases with leiomyomas ≥7 cm, compared to those with <4cm, had deliveries at earlier gestational weeks (36w6/7±2d vs. 37w+6/7±2d, p=0.018) and had lower newborn birthweight (2849.44±516.74 g vs. 3237.5±350.6 g, p<0.001), longer operation time (105.92±34.78 min vs. 68.21± 22.31 min, p<0.001) and a higher rate of neonatal intensive care unit requirement (48.1% vs. 13.7%, p<0.001). In cases with ≥2 leiomyomas compared to those with single leiomyomas, gestational age at birth was smaller and birthweight was lower (p<0.05). The amount of blood loss (969.66±427.21 mL vs. 738.15±337.2 mL and 553.84±366.46 mL), duration of surgery (83.23±29.56 min vs. 64.47±17.96 min) and transfusion requirements (36% vs. 5.3% and 28.8%) were higher in women who underwent myomectomy during cesarean section than in the other women undergoing only cesarean section or delivering vaginally (p<0.05).

CONCLUSION: It was found that a leiomyoma size of ≥7 cm and number of ≥2 were both associated with earlier gestational age at birth and lower birth weight. Myomectomy performed during cesarean section increased the blood loss, duration of surgery, and the need for transfusion.

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Published

2023-08-15

How to Cite

1.
Kose C, Korpe B, Kinay T, Yilmaz Ergani S, Karadeniz RS, Caglar AT, Engin Ustun Y. Maternal and Perinatal Outcomes of Pregnancies with Uterine Leiomyomas. Gynecol Obstet Reprod Med [Internet]. 2023Aug.15 [cited 2024Jul.23];29(2):99-106. Available from: https://www.gorm.com.tr/index.php/GORM/article/view/1333

Issue

Section

Obstetrics; Maternal Fetal Medicine and Perinatology