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Gynecol Obstet Fertil. 2010 Oct;38(10):569-75. doi: 10.1016/j.gyobfe.2010.08.001. Epub 2010 Sep 22.

[Leiomyoma during pregnancy: which complications?].

[Article in French]

Author information

  • 1Pôle de Gynécologie, Obstétrique, Médecine Fœtale et Reproduction Humaine, Hôpital Bretonneau, CHU de Tours, 2 Boulvard Tonnellé, 37044 Tours cedex 1, France.

Abstract

OBJECTIVE:

We have observed the association between uterine leiomyomas and complications during pregnancy, delivery and post-partum among our patients over the last 10 years.

PATIENTS AND METHODS:

We realized a retrospective case-control study comparing pregnancy and delivery outcomes in women with and without leiomyomas. In order to strengthen our observations, we conducted both univariate and multivariate analyses, and carefully respected 3 matching criteria between the two groups: age, parity and date of delivery.

RESULTS:

Over a ten-year period, 117 (0.38%) women with at least one leiomyoma would give birth - among the 30,805 births registered in our unit. By multivariate analysis, the presence of leiomyomas was significantly associated with women's age over 35 (adjusted odds ratio [AOR] 2.48, 95% confidence interval (CI) [1.31-4.67]), smoking (AOR=4.3, [1.82-10.13]), cystitis (AOR = 6.55, [2.12-20.16]), hydramnios (AOR = 5.12, [1.57-16.65]), threatened preterm labor (AOR = 3.99, [1.66-9.56]), first trimester bleeding (AOR = 3.92, [1.62-13.26]), anaemia during pregnancy (AOR = 2.97, [1.30-6.78]), labor dystocia (AOR = 11.79, [2.80-49.56]), retained placenta (AOR = 4.25, [1.49-12.11] and neonatal pediatric intensive care (AOR = 4.44, [1.19-16.60]). Regarding cesarean delivery, the multivariate analysis found that women with several leiomyomas underwent 8.48 times more cesarean sections than women with a single leiomyoma (p = 0.001).

DISCUSSION AND CONCLUSION:

Our study shows how specific features are to be kept in mind regarding obstetric outcomes for women with leiomyomas. These results emphasise the need for good perinatal care and raise the question of the treatment of those leiomyomas before pregnancy with the development of non-invasive procedures.

Copyright © 2010 Elsevier Masson SAS. All rights reserved.

PMID:
20864377
[PubMed - indexed for MEDLINE]
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