title: Growth trend of small uterine fibroids and human chorionic gonadotropin serum levels in early pregnancy: an observational study.
abstract: OBJECTIVE
  To analyze the growth trend of small uterine fibroids during early pregnancy, evaluating the potential factors involved, with particular interest in hCG levels.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  Women who had an ultrasound diagnosis of small myomas (diameter, ≥10 mm and ≤50 mm) from January 2007 to December 2013, and who subsequently became pregnant within 1 year.
  
  
  METHODS
  None.
  
  
  METHODS
  Three additional ultrasound examinations were performed during early pregnancy (7-8, 10-13, and 20-22 complete gestational weeks, respectively) and the modifications in diameter and volume of each uterine fibroid were recorded. A serial evaluation of hCG serum levels from 5-12 weeks was performed.
  
  
  RESULTS
  From the 109 women who fulfilled the study inclusion/exclusion criteria, a significant increase emerged, both for volume and diameter of the detected fibroids. Specifically, a median growth rate (GR) of 122% was observed during the interval of the first to the second ultrasound, whereas a median GR of 108% was detected during the interval between the second and the third ultrasound, and a median GR of 25% between the third and the fourth ultrasound. A significant positive correlation between hCG levels and diameter (R = 0.69) of myomas between 5 and 12 weeks emerged.
  
  
  CONCLUSIONS
  A remarkable nonlinear growth of small fibroids during initial pregnancy was observed, with a faster rate in the first trimester and a slowdown by midpregnancy. Those changes seem to be related to the similar increase of hCG levels until 12 weeks.
authors.affiliation: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy. Electronic address: ciavattini.a@libero.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ciavattini
authors.affiliation: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Delli Carpini
authors.affiliation: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Clemente
authors.affiliation: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Moriconi
authors.affiliation: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Gentili
authors.affiliation: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Di Giuseppe
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000097:blood* / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011262:Pregnancy Trimester, Second / Q000097:blood; D047368:Tumor Burden / Q000502:physiology*; D014594:Uterine Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging*
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin
keywords: Myomas; growth; hCG; pregnancy; volume