Uterine fibroid are a very common finding in women of reproductive age. The majority of fibroid do not change their size during pregnancy, but one-third may grow in the first trimester. Although the data are conflicting and most women with fibroid have uneventful pregnancies,
the weight of evidence in the literature suggests that uterine fibroid are associated with an increased rate of spontaneous miscarriage, preterm labor, placenta abruption, malpresentation, labor dystonia, cesarean delivery, and postpartum hemorrhage.
Key words: Fibroids, Miscarriage, Preterm labor, Placenta abruption, Fetal anomalies, Myomectomy, Uterine artery embolization
Fibroids (leiomyomas) are benign smooth muscle cell tumors of the uterus. Although they are extremely common, with an overall incidence of 40% to 60% by age 35 and 70% to 80% by age 50, the precise etiology of uterine fibroids remains unclear.
The diagnosis of fibroids in pregnancy is neither simple nor straightforward. Only 42% of large fibroids (> 5 cm) and 12.5% of smaller fibroids (3–5 cm) can be diagnosed on physical examination.
The ability of ultrasound to detect fibroids in pregnancy is even more limited (1.4%–2.7%) primarily due to the difficulty of differentiating fibroids from physiologic thickening of the myometrium.
The prevalence of uterine fibroids during pregnancy is therefore likely underestimated. Reflecting the growing trend of delayed childbearing, the incidence of
fibroids in older women undergoing treatment for infertility is reportedly 12% to 25%.Despite their growing prevalence, the relationship between uterine fibroids and adverse pregnancy outcome is not clearly understood.
