OUTCOME OF PREGNANCY WITH CLINICALLY VISIBLE/PALPABLE MYOMA AMONG WOMEN WHO UNDERGO CAESARIAN SECTION IN THREE TEACHING HOSPITALS, ADDIS ABABA, ETHIOPIA: A CROSS SECTIONAL STUDY

Authors

  • Eyasu Mesfin Ethiopian Society of Obstetricians & Gynecologists Ethiopian Public Health Association
  • Getu Dinku Ethiopian Society of Obstetricians & Gynecologists

Abstract

Introduction: Myoma is the most common pelvic tumor and an enormous healthcare concern in women. Complications occur in approximately 10-40% of pregnancies with myomatous uterus. This study is conducted to determine the prevalence and obstetric outcome of grossly visible and/or palpable myoma among women who gave birth by caesarean section.

Methods: A cross sectional study conducted in three teaching hospitals in Addis Ababa, Ethiopia. Data was collected using a pre-tested questioner.

Results: A total of 404 cases were included in the study. The prevalence of myoma was 15.3% (62/404). Only 9.7% (6/62) of the myoma cases were diagnosed preoperatively with ultrasound. The number of myoma per case ranged from 1-to-14 with mean number of 3 ±2.7. The mean diameter of largest single myoma per case was 5.2cm ± 3.4. The commonest location of myoma was subserous being the location in 58.1% (36/62). There was significant association between presence of myoma and age of the woman (P<0.05). The adjusted prevalence of myoma increases as women’s age increases, and gestational age and birth weight decreases. In addition, the prevalence of myoma was about two times higher in low (≤6) first and fifth minute APGAR score groups with adjusted prevalences of 22.2% (Vs 14.1% in ≥7 group) and 31.8% (Vs 14.4% in ≥7 group) respectively.

Conclusions: The prevalence of myoma during pregnancy in this study is higher than prior reports from similar setups. But, no statistically significant association was observed between the presence of myoma and maternal out come.

 

Key words: Myoma, Leiomyoma, Fibroid, Pregnancy with Myoma.

Author Biographies

Eyasu Mesfin, Ethiopian Society of Obstetricians & Gynecologists Ethiopian Public Health Association

Assistant professor, Department of Obstetrics & Gynecology,

CHS, School of Medicine, AAU, ADDIS ABABA, ETHIOPIA

Getu Dinku, Ethiopian Society of Obstetricians & Gynecologists

OBSTETRICIAN & GYNECOLOGIST

References

REFERENCES

Patricia E. and Susan P.: Uterine Fibroid Tumors: Diagnosis and Treatment, American Family Physician, 2007;75( 10)

Flake et al: Etiology and Pathogenesis of Uterine Leiomyomas: A Review, Environmental Health Perspectives, 2003; 111(8)

Qidwai GI, Caughey AB, Jacoby AF. Obstetric outcomes in women with sonographically identified uterine leiomyomata. Obstet Gynecol 2006; 107:376.

Laughlin SK, Baird DD, Savitz DA, et al. Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstet Gynecol 2009; 113:630.

Eze C. et al: Sonographic assessment of pregnancy co-existing with uterine leiomyoma in Owerri, Nigeria, African Health Sciences, 2013; 13(2):453 – 460

Fraser IS, Critchley HO, Munro MG, et al. A process designed to lead to international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding. Fertil Steril 2007; 87:466.

Muram D, Gillieson M, Walters JH. Myomas of the uterus in pregnancy: ultrasonographic follow-up. Am J Obstet Gynecol. 1980; 138:16–19.

Cooper NP, Okolo S. Fibroids in pregnancy common but poorly understood. Obstet Gynecol Surv.2005; 60:132–138.

Ouyang DW, Economy KE, Norwitz ER. Obstetric complications of fibroids. Obstet Gynecol Clin North Am. 2006; 33:153–69. [PubMed]

Exacoustòs C, Rosati P. Ultrasound Diagnosis of Uterine Myomas and Complications in Pregnancy. Obstet Gynecol. 1993; 82:97–101. [PubMed]

Shehla N.et al: pregnancy with fibroids and is obstetric complications, J Ayub Med Coll Abbottabad 2009;21(4)

Valerie I. et al: Adverse obstetric outcomes associated with sonographically identified large uterine fibroids, American Society for Reproductive Medicine, 2012; 97 (1)

Parker WH. Uterine myomas: management. Fertil Steril 2007; 88:255.

Stewart EA. Uterine fibroids. Lancet 2001; 357:293.

Gary N. and Marcus W. : Myomas and myomectomy, Journal of Minimally Invasive Gynecology,2005; 12( 5)

Guylaine L. et al: The management of uterine liomyomas, J Obstet Gynaecol Can 2003; 25(5):396–405

William H. et al: Etiology, symptomatology, and diagnosis of uterine Myomas, American Society for Reproductive Medicine, 2007; 87(4)

Strobelt N, Ghidini A, Cavallone M, et al. Natural history of uterine leiomyomas in pregnancy. J Ultrasound Med 1994; 13:399.

Baird DD, Dunson DB, Hill MC, et al. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol 2003; 188:100.

Elizabeth A.: Fibroids and infertility: an updated systematic review of the evidence American Society for Reproductive Medicine 2009:19(4)

Fla´vio G.: Impact of subserosal and intramural uterine fibroids that do not distort the endometrial cavity on the outcome of invitro fertilization–intracytoplasmic sperm injectionEuropean Society of Human Reproduction and Embryology, 2004:81(1)

Parazzini F, Negri E, La Vecchia C, Chatenoud L, Ricci E, Guarnerio P. Reproductive factors and risk of uterine fibroids. Epidemiology 1996;7: 440–2.

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2016-12-19

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