Dec 13, 2011

Large Fibroids Tied to Adverse Obstetric Outcomes

Pregnant women with large uterine fibroids are at significantly increased risk for delivery at an earlier gestational age and for excessive blood loss, researchers said recently.

Dr. Valerie I. Shavell and colleagues at Michigan’s Wayne State University School of Medicine and the Detroit Medical Center noted in a November 17th online paper in Fertility and Sterility that fibroids affect as many as 70% of women of reproductive age.

They say the impact of fibroids on pregnancy isn’t clear, but there is a trend toward a variety of adverse outcomes, including delivery at an earlier gestational age in women with fibroids of any size.

To investigate further, the team reviewed data on 95 women with singleton gestations and ultrasonic evidence of uterine fibroids. Forty-two of the women had fibroids greater than 5 cm in diameter.

Gestational age at delivery was significantly lower in those 42 women (36.5 weeks) than in the women with smaller fibroids (38.4 weeks) or in 95 age-matched controls (38.6 weeks).

In addition, 12.2% of the large fibroid group needed blood transfusion after delivery, compared to no patient with smaller fibroids and 1.1% of controls. Corresponding estimates for blood lost during delivery were 645.1, 535.6, and 486.8 mL.

Large fibroids were also significantly associated with short cervix, preterm premature rupture of membranes, and preterm delivery. The total number of large fibroids was correlated with these outcomes.

The researchers say “it is premature… to make specific recommendations regarding the value of myomectomy prior to conception in such women.”

However, given the findings, they conclude that women with large fibroids “should be counseled regarding the increased likelihood of these unfavorable obstetric outcomes.”

Dr. Shavell did not respond to requests for comments.

SOURCE: http://bit.ly/rBm4n8

Fertil Steril 2011.

— Reuters Health Information

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