title: [Uterine leiomyomas during pregnancy and its impact on obstetric outcome].
abstract: BACKGROUND
  The association of uterine leiomyoma and pregnancy is increasing due to the tendency of couples to delay first pregnancy after age 30. The risk of uterine fibroids is greater with advancing age of the woman.
  
  
  OBJECTIVE
  To evaluate the impact of fibroids on the incidence of complications during pregnancy, labor and delivery.
  
  
  METHODS
  We observed 65 pregnant patients with uterine fibroids and 165 pregnant patients without fibroids. Follow-up ultrasound was performed at weeks 20 to 24, 30 to 32 and 36 to 40. We analyzed the following variables: threatened abortion, pregnancy loss, preterm birth, premature rupture of membranes, abnormal fetal presentation, mode of termination of pregnancy, uterine atony, postpartum hemorrhage and perinatal outcome.
  
  
  RESULTS
  The frequency of threatened abortion, risk of pregnancy loss in the second trimester, preterm births, premature rupture of membranes and abnormal fetal presentation was significantly higher in patients with uterine fibroids compared to patients without fibroids. It was not demonstrated that fibroids grow during follow-up even, there was a trend toward reduction in size as pregnancy progressed and until its completion. No significant differences in the frequency of cesarean section between groups (52.3 vs. 47.9%, RR 1.09; 95% CI 0.82-1.45, p = 0.646). Uterine atony was more frequent in patients with fibroids than in patients without fibroids (12.3 vs 4.2%, RR = 2.9, 95% CI 1.2-7.6, p = 0.036). There were no differences in perinatal outcomes between the groups.
  
  
  CONCLUSIONS
  Uterine fibroids increase the risk of complications during pregnancy and childbirth. Could not be demonstrated an increased risk of caesarean section.
authors.affiliation: Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa, Hospital Civil de Culiacán, Sinaloa, México. fmorganortiz@hotmail.com
authors.forename: Fred
authors.initials: F
authors.lastname: Morgan Ortiz
authors.forename: Brizna
authors.initials: B
authors.lastname: Piña Romero
authors.forename: Enrique
authors.initials: E
authors.lastname: Elorriaga García
authors.forename: Josefina
authors.initials: J
authors.lastname: Báez Barraza
authors.forename: Everardo
authors.initials: E
authors.lastname: Quevedo Castro
authors.forename: Felipe de Jesús
authors.initials: Fde J
authors.lastname: Peraza Garay
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000033:Abortion, Threatened / Q000453:epidemiology; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007746:Labor Presentation; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000453:epidemiology*; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011256:Pregnancy Outcome; D016216:Ultrasonography, Prenatal; D014593:Uterine Inertia / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology*; D055815:Young Adult