[Leiomyoma during pregnancy: which complications?].
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.


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).


CONCLUSIONS
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.
Kellal
I
I
Pôle de Gynécologie, Obstétrique, Médecine Fœtale et Reproduction Humaine, Hôpital Bretonneau, CHU de Tours, 2 Boulvard Tonnellé, 37044 Tours cedex 1, France.
Haddouchi
N El
NE
Lecuyer
A-I
AI
Body
G
G
Perrotin
F
F
Marret
H
H
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D003556:Cystitis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D007889:Leiomyoma / Q000150:complications* / Q000453:epidemiology; D008423:Maternal Age; D007744:Obstetric Labor Complications / Q000453:epidemiology; D007752:Obstetric Labor, Premature; D006831:Polyhydramnios / Q000453:epidemiology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011644:Puerperal Disorders / Q000453:epidemiology; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000150:complications* / Q000453:epidemiology