Influence of uterine fibroids on the intrapartum maternal outcome:  A retrospective study.

Sonia H; M Swetha; Keerti Shivaputrappa

doi:10.51168/mg5q5z72

Authors

Dr. Sonia H Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India Author
Dr. Swetha K. M Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Author
Dr. Keerti Shivaputrappa Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Author

DOI:

https://doi.org/10.51168/mg5q5z72

Keywords:

uterine fibroids, leiomyoma, pregnancy, caesarean section, postpartum haemorrhage.

Abstract

Introduction

Uterine fibroids are common benign uterine tumours in women of reproductive age and can complicate labour through mechanical obstruction, altered uterine contractility, malpresentation, and postpartum haemorrhage. Their intrapartum influence varies according to fibroid size and anatomical location.

Materials and Methods

This hospital-based retrospective observational study included 120 pregnant women with documented uterine fibroids who delivered at a tertiary care teaching hospital in Bengaluru, India. Demographic, obstetric, ultrasonographic, intrapartum, and postpartum information was retrieved from hospital records. Fibroid number, size, location, lower uterine segment involvement, mode of delivery, caesarean indications, labour complications, postpartum haemorrhage, uterine atony, and transfusion requirement were assessed. Categorical associations were evaluated using appropriate tests, with p<0.05 considered statistically significant.

Results

Of the 120 women, 35.0% were aged 30–34 years, 30.8% were aged 25–29 years, and 19.2% were aged ≥35 years; 60.0% were multigravidas. Most delivered at 37–40 weeks (75.8%), and 88.3% had cephalic presentation. Caesarean delivery occurred in 58.3%, whereas 41.7% had vaginal delivery. Intramural fibroids were most frequent (51.7%), and 48.3% had fibroids <5 cm. Caesarean delivery increased with fibroid size: 50.0% for <5 cm, 61.2% for 5–10 cm, and 84.6% for >10 cm (p=0.027). Lower uterine segment involvement was associated with a higher caesarean rate (81.8% vs 53.1%; p=0.014). Labour dystocia occurred in 17.5%, postpartum haemorrhage in 13.3%, uterine atony in 10.8%, and blood transfusion in 7.5%.

Conclusion

Larger fibroids and lower uterine segment involvement were associated with increased caesarean delivery and clinically important maternal complications.

Recommendations

Antenatal assessment of fibroid size and location, individualized delivery planning, and preparedness for haemorrhagic complications are recommended.

Author Biographies

Dr. Sonia H, Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India

is an Assistant Professor in the Department of Obstetrics and Gynaecology at ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Her academic and clinical responsibilities are centred on obstetrics and gynaecology within a tertiary-care teaching environment
Dr. Swetha K. M, Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India.

is an Assistant Professor in the Department of Obstetrics and Gynaecology at ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. She contributes to clinical care, teaching, and scholarly work in obstetrics and gynaecology.
Dr. Keerti Shivaputrappa, Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India.

is an Assistant Professor in the Department of Obstetrics and Gynaecology at ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India, and is the corresponding author of this manuscript. Her professional work is based in clinical obstetrics and gynaecology, teaching, and research at the institution.

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