Unveiling the Complexities of Myomas in Pregnancy: A Prospective Observational Study

Objective: To assess the impact of fibroids on maternal and perinatal outcomes during pregnancy. Methods: The prospective observational study was conducted from September 2015 to August 2017, wherein all antenatal cases with fibroid uterus identified antenatally on ultrasound were evaluated for obstetrical outcome and followed-up to 6 weeks postpartum. All obstetric cases with an intraoperative diagnosis of fibroid were studied retrospectively. Results: Out of 11,383 women who delivered over a two-year period, 131 were diagnosed with fibroids. This represents an incidence rate of 8.69% for fibroids complicating pregnancy. The mean age of the patients was 30.2 years. Out of 131 patients, 113 patients delivered, within which 41 had a vaginal delivery and 72 underwent cesarean section. Fibroids were observed more frequently in primigravida women, with 73 cases (55.7%), compared to 56 cases (44.3%) in multigravida. Considering the antepartum complications, 18 women had abortion, 10 presented with pain, 21 had prelabor rupture of membranes (PROM), 10 had malpresentation and 9 went into preterm labor. The patients with submucosal fibroids were at risk of developing abortion when compared with other types of fibroids. About, 35 women underwent cesarean section due to fibroid related indication and 37 due to obstetric indication. Among 113 babies, 90 had an APGAR score more than 7/10 and 76% of the babies weighed more than 2.5 kg. Conclusion: Fibroids are often asymptomatic during pregnancy, but they can sometimes lead to complications that may impact the course of pregnancy and delivery. Therefore, diligent and comprehensive screening throughout pregnancy and the postpartum period is crucial to prevent unpropitious obstetric complications and enhance outcomes.