Symptomatic uterine fibroids in pregnancy — wait or operate? Own experience

El miometrio, la pared muscular del útero, puede modificar su misma masa y las propiedades celulares en el embarazo y también en los tumores como el leiomioma y el leiomiosarcoma. El leiomioma, dicho también fibroma, es un tumor benigno del útero y se considera como una de las causas más frecuentes de infertilità en el período reproductivo femenino. El leiomiosarcoma, en cambio, es un tumor maligno y agresivo de la musculatura lisa uterina. La presente revisión discute las características generales del leiomioma y el leiomiosarcoma y los relativos tratamientos clínicos actualmente usados y además describe las características del miometrio normal en el embarazo. The myometrium, the muscular wall of the uterus, can modify its mass and cellular properties in pregnancy as well as in tumor conditions such as leiomyoma and leiomyosarcoma. Leiomyomas, also known as fibroids, are benign tumors of the uterus, considered to be one of the most frequent causes of infertility in reproductive years of women. Leiomyosarcomas in turn, are rare aggressive malignant uterine smooth-muscle tumors. The present review is discussing the general features of leiomyoma and leiomyosarcoma with their current treatments and also discussing the characteristics of normal pregnant myometrium and compare with leiomyoma.

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Uterine fibroids in pregnancy: prevalence, clinical presentation, associated factors and outcomes at the Limbe and Buea Regional Hospitals, Cameroon: a cross-sectional study

BMC Research Notes ◽

10.1186/s13104-018-4007-0 ◽

2018 ◽

Vol 11 (1) ◽

Cited By ~ 4

Author(s):

Thomas Obinchemti Egbe ◽

Therese Gaelle Badjang ◽

Robert Tchounzou ◽

Eta-Nkongho Egbe ◽

Marcelin Ngowe Ngowe

Keyword(s):

Associated Factors ◽

Clinical Presentation ◽

Uterine Fibroids ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Regional Hospitals ◽

In Pregnancy

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Obstetrical Outcomes of Ultrasound Identified Uterine Fibroids in Pregnancy

American Journal of Perinatology ◽

10.1055/s-0036-1593389 ◽

2016 ◽

Vol 33 (12) ◽

pp. 1218-1222 ◽

Cited By ~ 4

Author(s):

Nicole Ulrich ◽

Sheena Duplantis ◽

Frank Williams ◽

Qingyang Luo ◽

Robert Moore ◽

...

Keyword(s):

Uterine Fibroids ◽

Obstetrical Outcomes ◽

In Pregnancy

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Comparative study between vaginal natural progesterone and oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20203318 ◽

2020 ◽

Vol 9 (8) ◽

pp. 3330

Author(s):

Nermeen M. Hefila ◽

Tarek A. Karkour ◽

Sara M. Elghareeb ◽

Tamer M. Abdeldaiem

Keyword(s):

Uterine Fibroid ◽

Gestational Age ◽

Uterine Fibroids ◽

Pregnant Females ◽

Significant Difference ◽

Group A ◽

Group B ◽

Red Degeneration ◽

In Pregnancy ◽

Natural Progesterone

Background: Uterine leiomyomas are highly prevalent benign monoclonal tumors, arising from the smooth muscle of the myometrium; they occur in up to 50-60% of reproductive age women, causing significant morbidity in up to 30% of women. The most serious complication of uterine fibroids; is red degeneration that causes severe pain, and may lead to preterm labour, miscarriage, fetal and maternal morbidity and mortality. Objective of this study was designed to compare between the effect of vaginal natural MP and oral dydrogesterone in prevention of red degeneration of uterine fibroid during pregnancy.Methods: Patients were recruited from El-Shatby Maternity University Hospital. They were 50 pregnant females, diagnosed having a uterine fibroid more than 3 cm in size then there were divided into two groups, Group A: twenty-five treated by vaginal natural progesterone, Group B: twenty-five treated by oral dydrogesterone. All patients at 14-15 weeks of gestational age underwent complete history taking, clinical examination and ultrasound examination for mean gestational age and assessment of the type and uterine fibroid.Results: Results showed that there were no statistically significant differences as regards age, obstetric history (gravidity and parity), number, Site, grade and size of the fibroid. There was a significant difference between the two studied groups, regarding the acute abdominal pain, it occurred to only 3 cases (12%) in Group A, versus to 16 cases (64%) in Group B. Regarding occurrence of red degeneration, it occurred only to 3 cases (12%) in Group A, while in Group B it occurred to 15 cases (60%).Conclusions: Vaginal natural micronized progesterone is more effective than oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy with fewer complications. Vaginal natural progesterone daily dose of 200 mg is recommended to all pregnant females with uterine fibroids.

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Large Uterine Fibroids in Pregnancy with Successful Caesarean Myomectomy

Case Reports in Obstetrics and Gynecology ◽

10.1155/2020/8880296 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Edu Eyong ◽

Okon A. Okon

Keyword(s):

Birth Weight ◽

Uterine Fibroid ◽

Reproductive Tract ◽

Uterine Fibroids ◽

Female Reproductive Tract ◽

Benign Tumour ◽

First Line ◽

Female Baby ◽

In Pregnancy

Uterine fibroid is the commonest benign tumour of the female reproductive tract. It occurs in 20–40% of women, whereas the estimated incidence in pregnancy is 0.1–3.9%. Uterine fibroid in pregnancy is usually asymptomatic with complications occurring in 10–30% of cases. The first line of management is conservative with counselling for myomectomy after delivery. However, in the presence of intractable symptoms, both antepartum myomectomy and caesarean myomectomy have been reported to be successfully performed in carefully selected cases. We report a case of large subserous uterine fibroid in pregnancy that was referred to our centre at 14 weeks of gestation. She developed generalized body weakness, backache, and breathlessness at 27 weeks gestation. Thus, she was admitted and managed conservatively for eight weeks with significant relief of symptoms. She eventually had a caesarean myomectomy at 35 weeks of gestation; the outcome was a live female baby with a birth weight of 2.3 kg and a large subserous fibroid weighing 9.5 kg. We can therefore say that caesarean myomectomy can be safely performed in carefully selected cases.

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Management of uterine fibroids in pregnancy

Current Opinion in Obstetrics & Gynecology ◽

10.1097/gco.0000000000000220 ◽

2015 ◽

Vol 27 (6) ◽

pp. 432-437 ◽

Cited By ~ 33

Author(s):

Salvatore G. Vitale ◽

Francesco Padula ◽

Ferdinando A. Gulino

Keyword(s):

Uterine Fibroids ◽

In Pregnancy

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Surgical Treatment of “Large Uterine Masses” in Pregnancy: A Single-Center Experience

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182212139 ◽

2021 ◽

Vol 18 (22) ◽

pp. 12139

Author(s):

Anna Franca Cavaliere ◽

Annalisa Vidiri ◽

Salvatore Gueli Alletti ◽

Anna Fagotti ◽

Maria Concetta La Milia ◽

...

Keyword(s):

Surgical Treatment ◽

Uterine Fibroids ◽

First Trimester ◽

Second Trimester ◽

Histologic Diagnosis ◽

Single Center Experience ◽

Fetal Complications ◽

Benign Nature ◽

The Masses ◽

In Pregnancy

Uterine myomas or uterine fibroids are the most common benign uterine masses affecting women. The management of large myoma during pregnancy is challenging, and surgical treatment is a possible option. We report nine cases of pregnant women affected by uterine masses larger than 10 cm, who underwent surgical treatment during the second trimester of pregnancy. In all cases, the masses were preconceptionally unknown and diagnosed during the first trimester. In eight cases, no maternal and fetal complications arose during or after surgical treatment and delivery occurred at full term of pregnancy. In one case, spontaneous abortion was recorded. In all cases, histologic diagnosis demonstrated the benign nature. Women affected by large uterine masses diagnosed for the first time in pregnancy could be taken into consideration for surgical treatment in a referral center during the second trimester.

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Management in cases of large uterine myomas in pregnancy

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2019-0059 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Aleksandra Stupak ◽

Marcin Bobiński ◽

Andrzej Miturski ◽

Barbara Kalbarczyk ◽

Anna Kwaśniewska ◽

...

Keyword(s):

Pregnant Woman ◽

Pain Control ◽

Clinical Observation ◽

Uterine Fibroids ◽

Reproductive Organs ◽

Benign Tumors ◽

Premature Delivery ◽

Case Presentation ◽

Uterine Myomas ◽

In Pregnancy

AbstractObjectivesUterine fibroids are the most common benign tumors in women of procreative age. The effects of their occurrence affect the course of pregnancy by increasing the frequency of abortions, premature delivery or premature abruption of the placenta. Medical treatment includes clinical observation, pharmacological pain control, myomectomy during pregnancy or perinatal hysterectomy.Case presentationWe present a survey of literature and the case of a pregnant woman with an enormous uterine fibroid 23×13×16 cm on the basis of which a diagnostic-therapeutic scheme for tumors of the reproductive organs during pregnancy has been developed.ConclusionsThe study presents improved recommendations for management the pregnancies in presence of the uterine myomas based on clinical practice.

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