Maternal and Fetal Outcome in Pregnancy with Fibroids: A Prospective Study

Background: Fibroid (myomas) is the most common benign tumors of the uterus. Complications occur in approximately 10-40% in the presence of fibroids. The aim of our study was to evaluate the maternal and fetal outcome in antenatal women with fibroids. Methods: A prospective study was carried out over a period of 1-year in 30 women admitted with the diagnosis of pregnancy with fibroid. Duration of study was from 1.08.2014 to 30.07.2015, 1 year in a tertiary care medical college hospital, Raja Mirasdar Hospital attached to Thanjavur Medical College, Thanjavur, Tamil Nadu, India. Routine basic investigations were done for all the women included in the study. Ultrasonogram was done at booking visit and during subsequent visits to assess the increase in the size of the fibroid and degeneration and other obstetric complications such as malpresentation and placenta previa. Results: Major proportion was in the younger age group of 25-35 years. Fibroids were more frequent in multigravidae 22 (73.3%), and primigravidae were 8 (26.6%). The reported incidence of fibroid in pregnancy ranges from 0.01%-10.7%. 10 (33.3%) women were asymptomatic during pregnancy. Out of 30 women, 10 (33.3) were known the case of fibroid became pregnant, remaining 20 (66.6%) were diagnosed as having fibroid during routine antenatal visits. 7 women (23.3%) had pain, 4 of them (13.3%) had threatened preterm labor, 3 (10%) had spontaneous miscarriage, and 3 (10%) had anemia, and placenta previa was diagnosed in 3 patients (10%). 27 women (90%) were crossed 37 completed weeks of gestation. Out of 27, 8 (29.6%) women had vaginal delivery, outlet forceps applied in one woman (3.7%), and ventouse applied in one woman (3.7%). Lower segment cesarean section done in 16 women (59.2%), and cesarean hysterectomy proceeded in one woman (3.7%). Conclusion: Pregnancies with fibroids are associated with complications during the antepartum, intrapartum, and postpartum 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.