Prevalence of Uterine Myomas Among Women with 2 or More Recurrent Pregnancy Losses: A Systematic Review

被引:7
作者
Russo, Miguel [1 ]
Suen, Michael [2 ]
Bedaiwy, Mohamed [2 ]
Chen, Innie [1 ]
机构
[1] Univ Ottawa, Ottawa Hosp, Dept Obstet & Gynaecol, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada
[2] Univ British Columbia, BC Womens Hosp, Dept Obstet & Gynaecol, Vancouver, BC, Canada
关键词
Hysteroscopy; Leiomyoma; Myomas; Myomectomy; Recurrent pregnancy loss; HYSTEROSCOPIC FINDINGS; FIBROIDS; MISCARRIAGE; LEIOMYOMAS; ANOMALIES; BIRTH;
D O I
10.1016/j.jmig.2016.03.018
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Recurrent pregnancy loss (RPL), defined as 2 or more failed clinical pregnancies, affects approximately 5% of reproductive women. Several etiologies for RPL have been studied including uterine myomas. However, the effect of uterine myomas on pregnancy outcomes in this patient population remains unclear. The purpose of this systematic review was to critically appraise the evidence associating uterine myomas with RPL and quantify the prevalence of uterine myomas in this patient population. The inclusion criteria included women of reproductive age with at least 2 or more recurrent, failed clinical pregnancies found to have a submucosal and/or intramural myoma distorting the uterine cavity on a hysterosalpingogram, a saline infusion sonogram, and/or hysteroscopy. Studies with biochemical pregnancies; molar, ectopic, and pregnancies of unknown location; pregnancies conceived with assisted-reproductive technologies; therapeutic abortions; subserosal myomas and intramural myomas not distorting the uterine cavity; studies using only 2-dimensional pelvic ultrasound; or studies in which no additional workup for RPL was initiated or in which multiple etiologies were included were omitted from this review. Risk of bias and quality assessment were conducted using the Quality Assessment Tool for Observational Cohort and Cross-sectional studies published by the National Institutes of Health. The electronic search yielded 934 citations. After title, abstract, and full-text screening, 3 studies had met the pre-established inclusion/exclusion criteria and were included in the review. The prevalence of submucosal and cavity-distorting myomas in women with 2 or more pregnancy losses was found to be 4.08% (29/711). The prevalence of uterine myomas was highest in women with 3 or more RPLs (5.91% [28/473]). No studies with a proper control group were identified. In summary, the association between uterine myomas and RPL remains unclear. High-quality studies are required to assert the impact of uterine myomas on pregnancy outcomes in this patient population. Patients with RPL and uterine myomas should be properly counseled regarding the existing evidence before surgical consideration. (C) 2016 AAGL. All rights reserved.
引用
收藏
页码:702 / 706
页数:5
相关论文
共 35 条
[2]   Myomas and reproductive function [J].
不详 .
FERTILITY AND STERILITY, 2008, 90 :S125-S130
[3]  
[Anonymous], 2002, INT J GYNECOL OBSTET, V78, P179
[4]  
[Anonymous], 2014, Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies
[5]  
[Anonymous], 2011, TOP G INVESTIGATION
[6]  
ASHTON D, 1988, OBSTET GYNECOL, V72, P28
[7]   Should endometrial biopsy be a routine investigation for recurrent early-pregnancy loss? [J].
Badawy, AM ;
El-Gharib, ME ;
Zalata, K .
GYNAECOLOGICAL ENDOSCOPY, 2002, 11 (06) :397-399
[8]   Outcome of pregnancies in women with uterine leiomyomas identified by sonography in the first trimester [J].
Benson, CB ;
Chow, JS ;
Chang-Lee, W ;
Hill, JA ;
Doubilet, PM .
JOURNAL OF CLINICAL ULTRASOUND, 2001, 29 (05) :261-264
[9]   Hysteroscopic findings in women with two and with more than two first-trimester miscarriages are not significantly different [J].
Bohlmann, Michael K. ;
von Wolff, Michael ;
Luedders, Doerte W. ;
Beuter-Winkler, Petra ;
Diedrich, Klaus ;
Hornemann, Amadeus ;
Strowitzki, Thomas .
REPRODUCTIVE BIOMEDICINE ONLINE, 2010, 21 (02) :230-236
[10]   The Management of Uterine Fibroids in Women With Otherwise Unexplained Infertility [J].
Carranza-Mamane, Belina ;
Havelock, Jon ;
Hemmings, Robert ;
Cheung, Anthony ;
Sierra, Sony ;
Carranza-Mamane, Belina ;
Case, Allison ;
Dwyer, Cathie ;
Graham, James ;
Havelock, Jon ;
Hemmings, Robert ;
Liu, Kimberly ;
Murdock, Ward ;
Vause, Tannys ;
Wong, Benjamin .
JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA, 2015, 37 (03) :277-285