FIBROIDS IN PREGNANCY;

OBSTETRIC COMPLICATIONS IN 3RD TRIMESTER

Abstract

Objectives: The objective of this study was to determine the frequency of
complications in pregnant women with fibroids in 3rd trimester. Study design: Descriptive Case
Series. Setting: Department of Obstetrics & Gynecology, Nishtar Hospital, Multan. Period: 15th
December 2014 to 15th June 2015. Subjects & Methodology: Where sample size was calculated
using WHO sample size calculator using expected proportion of intrauterine growth restriction
p= 4%.11 163 pregnant women of 20-40 year of age with uterine fibroid of ≥3cm on ultrasound
were included in this study. Patients of endometriosis and hypertension were excluded. An
obstetrical ultrasonography was done to confirm singleton pregnancy, size of uterine fibroid
and to confirm gestational age. Patients were monitored until delivery and complications were
recorded. Preterm labour was defined as dilation of the cervix <4cm with the presence of
uterine contractions of ≥ 4 per hour of 30 seconds duration with intensity to effect progressive
effacement, assessed by vaginal examination. Malpresentation was defined as a presentation
in which baby’s bottom or feet, instead of head, are in position relative to the maternal pelvis by
ultrasound and IUGR was defined as fetal weight below the 10th percentile and fetal abdominal
circumference below the 10th percentile on ultrasound. Results: Age range in this study
was from 20 to 40 years with mean age of 32.773±1.99 years, mean gestational age
34.730±2.44 weeks, fibroid size 5.736±1.51cm, duration of complain 5.018±1.41 months,
height 1.561±0.11 meters, mean weight 73.619±13.66 Kg and mean BMI was 28.607±3.106
Kg/m2. Majority of the patients were from 31-40 year group (89%). Preterm labour was seen
in 15.3% patients, malpresentation was 7.4% and IUGR was seen in 6.1% patients. Conclusion:
Our study conclude that, most common complication of uterine fibroids during pregnancy was
preterm labour followed by malpresentation and IUGR.