Management of uterine fibroids in pregnancy: recent trends.
OBJECTIVE
The review analyzes how fibroids may influence pregnancy and how myomas may be modified by pregnancy. The most important clinical aspect concerns the impact of myoma on pregnancy and the possibility of a well tolerated surgical treatment for the mother and her fetus, preserving maternal reproductive capacity.


RESULTS
Fibroids significantly increase in size during early pregnancy and then decrease in the third trimester. Although most women with uterine fibroids have a regular pregnancy, data from the literature suggest that they may have a higher risk of fertility problems and pregnancy complications.


CONCLUSIONS
Myomectomy can increase the rate of pregnancy in women with infertility, attempting to restore a normal anatomy and reduce uterine contractility and local inflammation associated with the presence of fibroids, improving the blood supply. Current evidence does not suggest routine myomectomy during pregnancy or at the cesarean birth, as fibroids-related complications are rare and may be overcome by the risks of surgery. However, in selected cases, myomectomy is a feasible and safe technique and associated to a good outcome.The diagnosis of myomas in pregnancy may require attention for the adequate management to preserve maternal and fetal well-being.
aDepartment of General Surgery and Medical Surgical Specialties, University of Catania, Catania bAltamedica, Fetal-Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy.
Salvatore G
SG
Vitale
Francesco
F
Padula
Ferdinando A
FA
Gulino
D000328:Adult; D000075202:Contraindications; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology / Q000628:therapy*; D018570:Risk Assessment; D016896:Treatment Outcome; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000473:pathology / Q000628:therapy*; D014599:Uterus / Q000098:blood supply* / Q000473:pathology