Higher rates of tachysystole among patients with clinically apparent uterine leiomyomas.
OBJECTIVE
This study was undertaken to determine uterine and fetal heart rate (FHR) tracing patterns associated with clinically apparent uterine leiomyomas.


METHODS
Uterine and FHR patterns of 44 women with diagnosed uterine leiomyomas were compared with 601 tracings of controls. Tracings were interpreted during the first stage of labor, using the National Institute of Child Health and Human Development Research Planning Workshop guidelines. Stratified analysis that used the Mantel-Haenszel technique was performed to control for confounders.


RESULTS
Patients with leiomyomas had higher rates of uterine tachysystole as compared with those without leiomyomas (22.7% vs 1.3%; odds ratio [OR] = 21.8, 95% CI 7.4-65.6; P < .001). No significant differences were noted between the groups regarding FHR patterns. Higher rates'of prostaglandin induction and oxytocin augmentation were noted in the uterine leiomyomas group (6.8% vs 0.8%; P = .005 and 52.3% vs 10.5%; P < .001, respectively). However, controlling for prostaglandin induction and oxytocin augmentation, with the use of the Mantel-Haenszel procedure, did not change the significant association between uterine leiomyomas and tachysystole (weighted OR 12.5, 95% CI 6.2-75.1, and weighted OR 8.7, 95% CI 3.6-43.1, respectively).


CONCLUSIONS
Clinically apparent uterine leiomyomas, although not coupled with abnormal FHR patterns, are associated with higher rates of tachysystole.
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheeva, Israel. sheiner@bgumail.bgu.ac.il
Eyal
E
Sheiner
Tamar
T
Biderman-Madar
Miriam
M
Katz
Amalia
A
Levy
Amnon
A
Hadar
Moshe
M
Mazor
D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D007743:Labor, Obstetric; D007889:Leiomyoma / Q000503:physiopathology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000503:physiopathology*; D013599:Systole; D014594:Uterine Neoplasms / Q000503:physiopathology*; D014599:Uterus / Q000098:blood supply* / Q000503:physiopathology