Title: How Do Uterine Leiomyomas affect the course of Pregnancy and Labor– A Prospective Study
Authors: Dr Anjan Dasgupta, Sanghamitra Dasgupta
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.28
Abstract
Prevalence of uterine leiomyoma among pregnant women is approximately 2% and more common in primipara. Leiomyoma with pregnancies are always at high risk as it may be associated with a number of complications like abortion, preterm labor, premature rupture of membranes (PROM), malpresentation, low lying placenta, intrauterine growth restriction (IUGR) and many others. During labor, dystocia, operative interferences like LUCS and post partum hemorrhage (PPH) are often encountered.
Objective: To evaluate the effects of leiomyoma on the course of pregnancy, labor and mode of delivery.
Materials and Method: The study was a prospective and observational study and carried out in a tertiary care hospital of city Kolkata, West Bengal with ethical approval. The study population included the antenatal mothers who attended antenatal OPD from the first trimester of pregnancy. A total of 102 mothers were taken in the study group as case-control study. Group L (n=51), consist of the pregnant mothers having USG confirmed leiomyoma with pregnancy, considered as case. Leiomyoma size of at least 3cm in diameter was included in the study. Group C (n=51) was the pregnant mothers relatively matched with age, parity and gestational weeks with group L, but without having uterine leiomyoma, served as control.
Results: Major portion of pregnant mothers with leiomyoma belonged to nulliparous group. There was higher percentage of termination of pregnancy before 28 weeks (p<0.05), preterm labor (p<0.05), LUCS (p<0.05), PPH (p<0.05), low birth weight baby (p<0.05) and lower percentage of vaginal delivery (p<0.05) among pregnancy with leiomyoma group (Group- L) compared to pregnancy without leiomyoma group (Group-C).
Conclusion: Uterine leiomyoma may adversely affect the course of pregnancy, labor and mode of delivery.
Keywords: Leiomyoma, Preterm labor, PROM, Malpresentation, IUGR, LUCS, PPH.
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