Assessment of adverse pregnancy outcomes in women presenting with uterine fibroids at a tertiary care hospital.

Abstract

Objective: To determine frequency of adverse pregnancy outcomes in women presenting with uterine fibroids at a tertiary care hospital. Study Design: Descriptive Case Series. Setting: Department of Obstetrics & Gynaecology, Nishtar Hospital, Multan. Period: 25^th November 2020 to 24^th June 2021. Material & Methods: The detailed history was taken and patients were examined thoroughly. Data was collected for basic demographics i.e. Age, parity, BMI, duration of complaints and pregnancy outcomes. Patients were booked and followed up for the pregnancy outcomes like preterm labour and post-partum hemorrhage. Results: Mean age of our study cases was noted to be 28.98 ± 3.68 years. Mean duration of fibroids was noted to be 26.46 ± 8.11 months and most of them i.e. 86 (53.8%) presented with duration of disease for more than 2 years. Mean body mass index of our study cases was noted to be 26.21 ± 2.14 kg/m² and obesity was present in 47 (29.4 %) of our study cases. Mean gestational age was noted to be 37.11 ± 3.09 weeks and 100 (62.4%) had gestational age more than 34 weeks. Large fibroids were observed in 21 (13.1 %), small in 48 (30 %), single fibroids in 39 (24.4 %), multiple fibroids in 39 (24.4 %), intramural in 7 (4.4%) and submucosal in 6 (3.8%). Preterm labor was noted in 88 (55 %) and Postpartum hemorrhage was noted in 66 (41.3 %) of our study cases. Conclusion: Uterine fibroids are associated with significantly increased adverse pregnancy outcomes as the frequencies of preterm births and postpartum hemorrhage were very high in our study. Preterm births were significantly associated with age, parity, obesity and characteristics of fibroids. Postpartum hemorrhage was significantly associated with age, parity, residential status, obesity and characteristics of fibroids.