Document Detail


Obstetric complications of fibroids.
MedLine Citation:
PMID:  16504813     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effect of uterine fibroids on fecundity and pregnancy outcome is difficult to determine with any degree of accuracy; this is due, in large part, to the lack of adequate large clinical trials. In general, the literature tends to underestimate the prevalence of fibroids in pregnancy and overestimate the complications that are attributed to them. In contrast to popular opinion, most fibroids do not exhibit a significant change in volume during pregnancy, although those that do increase in size tend to do so primarily in the first trimester. Although most pregnancies are unaffected by the presence of uterine fibroids, large submucosal and retro-placental fibroids seem to impart a greater risk for complications, including pain (degeneration), vaginal bleeding, placental abruption, IUGR, and preterm labor and birth. Preconception myomectomy to improve reproductive outcome can be considered on an individual basis, but likely has a place only in women who have recurrent pregnancy loss, large submucosal fibroids, and no other identifiable cause for recurrent miscarriage. Antepartum myomectomy should be reserved for women who have subserosal or pedunculated fibroids and intractable fibroid pain that are unresponsive to medical therapy and who are in the first or second trimester of pregnancy. Myomectomy at the time of cesarean delivery is associated with significant morbidity (hemorrhage) and should be pursued with caution and only in select patients.
Authors:
David W Ouyang; Katherine E Economy; Errol R Norwitz
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Obstetrics and gynecology clinics of North America     Volume:  33     ISSN:  0889-8545     ISO Abbreviation:  Obstet. Gynecol. Clin. North Am.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-28     Completed Date:  2006-07-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8709551     Medline TA:  Obstet Gynecol Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  153-69     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Gynecology & Reproductive Biology, Brigham & Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. douyang@partners.org
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MeSH Terms
Descriptor/Qualifier:
Clinical Trials as Topic
Female
Humans
Leiomyoma / complications*,  ultrasonography
Pregnancy
Pregnancy Complications, Neoplastic / ultrasonography
Pregnancy Outcome
Treatment Outcome
Ultrasonography, Prenatal
Uterine Neoplasms / complications*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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