title: Pregnancy outcome and uterine fibroids.
abstract: Myomas are observed in about 3-12% of pregnant women. Uterine fibroids may affect the outcome of pregnancy. The presence of myomas - in particular of myomas that distort the uterine cavity and larger intramural myomas - has been associated with infertility. In the case of pregnancy, it has been linked to an increased risk of spontaneous abortion, fetal malpresentation, placenta previa, preterm birth, cesarean section, and peripartum hemorrhage. Although fibroids may negatively affect pregnancy outcome, the impact of their treatment, particularly in quantitative terms, is unclear. Hysteroscopic myomectomy is the treatment of choice for submucous fibroids. The comparative efficacy of laparoscopic, laparotomic, or new modalities of treatment of intramural fibroids is not known. Up to date the choice and modalities of treatment of submucous fibroids should not be based on sound evidence but on clinical concerns and the skill of each center.
authors.affiliation: Fondazione IRCCS Cà Granda, Dipartimento Materno-Infantile, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Commenda 12, 20122, Milan, Italy; Dipartimento di Scienze Cliniche e di Comunità, Universita' di Milano, Via Commenda 12, 20122, Milan, Italy. Electronic address: fabio.parazzini@unimi.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Parazzini
authors.affiliation: Fondazione IRCCS Cà Granda, Dipartimento Materno-Infantile, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Commenda 12, 20122, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Tozzi
authors.affiliation: Dipartimento di Scienze Cliniche e di Comunità, Universita' di Milano, Via Commenda 12, 20122, Milan, Italy; UOC Ostetricia e Ginecologia IRCCS Multimedica Ospedale S. Giuseppe, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bianchi
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000037:Abruptio Placentae / Q000453:epidemiology; D001946:Breech Presentation / Q000453:epidemiology; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D047368:Tumor Burden; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: fibroids; miscarriage outcome treatment; pregnancy