title: Obstetrical Outcomes of Ultrasound Identified Uterine Fibroids in Pregnancy.
abstract: Objective We aimed to determine if fibroids in pregnancy, categorized by size, are associated with adverse obstetrical outcomes. Study Design Demographic, clinical, and delivery data were collected from charts of women with singleton gestations who delivered at >20 weeks gestation with fibroids identified at routine anatomy scan and their randomly selected age-matched controls. Largest fibroid diameter was used to categorize small fibroids (≤5 cm) and large fibroids (>5 cm). Results We included 450 patients: 264 patients with fibroids (174 small, 90 large fibroids) and 186 age-matched controls. Women with large fibroids had significantly greater blood loss than women with small fibroids and women with no fibroids (p-value <0.0001 and <0.0001 after adjusting for delivery mode). When fibroid size was compared individually, there was a significantly higher rate of primary cesarean section in both small and large fibroid groups when compared with women with no fibroids (p-values 0.044 and 0.003 after adjusting for body mass index). Conclusion Women with fibroids in pregnancy have higher rates of primary cesarean delivery and are at significant risk for increased blood loss at the time of delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, Ochsner Clinic Foundation, New Orleans, Louisiana.
authors.forename: Jane
authors.initials: J
authors.lastname: Martin
authors.affiliation: Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, Ochsner Clinic Foundation, New Orleans, Louisiana.
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Ulrich
authors.affiliation: Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, Ochsner Clinic Foundation, New Orleans, Louisiana.
authors.forename: Sheena
authors.initials: S
authors.lastname: Duplantis
authors.affiliation: Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, Ochsner Clinic Foundation, New Orleans, Louisiana.
authors.forename: Frank B
authors.initials: FB
authors.lastname: Williams
authors.affiliation: Office of Biostatistical Support, The Center for Applied Health Services Research, Ochsner Clinic Foundation, New Orleans, Louisiana.
authors.forename: Qingyang
authors.initials: Q
authors.lastname: Luo
authors.affiliation: Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, Ochsner Clinic Foundation, New Orleans, Louisiana.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Moore
mesh_terms: D000328:Adult; D001810:Blood Volume; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D006473:Postpartum Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging* / Q000473:pathology; D047368:Tumor Burden; D014594:Uterine Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology