Uterine fibroid size modifications during pregnancy and puerperium: evidence from the first systematic review of literature

Vitagliano, Amerigo; Noventa, Marco; Sardo, Attilio Di Spiezio; Saccone, Gabriele; Gizzo, Salvatore; Borgato, Shara; Vitale, Salvatore; Laganà, Antonio Simone; Nardelli, Giovanni Battista; Litta, Pietro; Saccardi, Carlo

doi:10.1007/s00404-017-4621-4

Cited by 82 publications

(66 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, the modification of myomas during the second and third trimesters is not definite: probably uterine myomas let up their growth in mid pregnancy, and their size decreases during the last period of pregnancy. Also, during the pregnancy, the total modification of fibroids does not appear to be understandable [43]. During pregnancy, the surgical treatment of myomas is performed in selected cases: torsion of pedunculated fibroid, necrosis of myoma with consequent peritoneal inflammation; in fact, the risk of myomectomy and surgical complications, also during caesarean section, overcome the benefits of conservative approach.…”

Section: Discussionmentioning

confidence: 99%

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Gardella

Dominoni

Iacobone

et al. 2018

Gynecol Obstet Invest

View full text Add to dashboard Cite

Background: This work analyzes the feasibility and effectiveness of barbed suture during laparoscopic myomectomy. Methods: Eight works have been carefully examined for the meta-analysis from all papers published online until November 2017. Results: Barbed suture proved to be superior to traditional suture technique in blood loss in laparoscopic myomectomy (Standardized Mean Difference [SMD] –0.650, 95% CI –1.420 to –0.119, p = 0.098, test for heterogenity p < 0.0001, I² = 95.54%), Hb drop (SMD –1.452, 95% CI –3.590 to 0.687, p = 0.183, test for heterogenity p < 0.0001, I² = 99.08%), suturing difficulty (SMD –0.638, 95% CI –0.935 to –0.342, p ≤ 0.001, test for heterogenity p = 0.25, I² = 27.84%), suturing time (SMD –1.197, 95% CI –1.848 to –0.549, p ≤0.001, test for heterogenity p = 0.0001, I² = 83.30%) and total operative time (SMD –0.687, 95% CI –0.804 to –0.569, p ≤ 0.001, test for heterogenity p = 0.292, I² = 17.44%). Barbed suture demonstrated to be better in comparison with the control group even with regard to the length of hospitalization (SMD –0.278, 95% CI –0.543 to 0.012, p = 0.040, test for heterogenity p = 0.025, I² = 61.85%), and to perioperative complications (SMD 0.708, 95% CI 0.503–0.996, p = 0.048, test for heterogenity p = 0.79, I² = 0%). Conclusion: Barbed suture significantly facilitates laparoscopic myomectomy by reducing the total operative/suturing time, estimated blood loss/Hb drop, and reduction of perioperative complications.

show abstract

Section: Discussionmentioning

confidence: 99%

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Gardella

Dominoni

Iacobone

et al. 2018

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…In general, UF may grow during the first trimester, while growth during the second and third trimester is very rare in order to produce obstetrical /perinatal complications. 43,44 UF growth may be related to the chorionic gonadotropin secretion, 45 although not significantly linked to the risk of miscarriage. 13 Pregnancy and delivery complications are usually more frequent in women aged more than 30 years 46 ; as was the case in the studies we meta-analyzed.…”

Section: Discussionmentioning

confidence: 95%

Uterine fibroids and preterm birth risk: A systematic review and meta‐analysis

Pérez-Roncero

López‐Baena

Ornat

et al. 2020

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Aim This study explored the association between the presence of uterine fibroids (UF), as determined by ultrasound, and preterm birth (PB) risk. Methods Medline, Embase, Cochrane, Scopus and Web of Science databases. Studies reporting women with and without UF demonstrated by an ultrasound exam. The primary outcome was the risk of PB < 37 weeks of gestation in pregnancies with UF diagnosed by an obstetric ultrasound exam. Effects for dichotomous and continuous outcomes are, respectively, reported as risk ratios (RR) or mean differences and their 95% confidence intervals (CI). Results Eighteen studies were included comprising 276 172 pregnancies to whom obstetric ultrasound assessment was performed for the presence/absence of UF. Women with UF were older (mean difference = 2.40 years, 95% CI 0.94–3.85) and were at higher risk of PB before 37 (RR = 1.43, 95% CI 1.27–1.60), 34 (RR = 1.79, 95% CI 1.32–2.42), 32 (RR = 1.94, 95% CI 1.33–2.85) and 28 (RR = 2.17, 95% CI 1.48–3.17) weeks as compared to those without UF (P < 0.01). In addition, women with UF were at higher risk of threatened preterm labor, preterm premature rupture of membranes, fetal malpresentation, placental abruption, lower gestational age and birthweight at delivery and a higher cesarean delivery rate. Conclusion Pregnant women with UF are at increased risk of PB and other adverse obstetric outcomes.

show abstract

“…Various studies have revealed that 60-70% of fibroids in antenatal women show no change in volume. Around 22-32% show increase in volume, especially in first trimester, with very minimal change in volume in second and third trimesters [6].…”

Section: A Rare Case Of Large Uterine Myoma In An Antenatal Women Witmentioning

confidence: 93%

“…All the investigations including complete blood count, Liver function fest, Renal function test, were sent and were within normal limits with hemoglobin 9.2 g/dl and incidence further increases with the advancing age of mother [9]. They rarely show any change in size during pregnancy but can increase in size and volume in first trimester and very rarely in second and third trimester [6] but unlike in this case the fibroid was rapidly growing in second trimester both in size and volume [6]. The exact pathogenesis of these smooth muscle tumours is not clear, but the two main ovarian steroidal hormones; oestradiol and progesterone play a significant role in its growth.…”

Section: Case Reportmentioning

confidence: 99%

A Rare Case of Large Uterine Myoma in an Antenatal Women with Situs Inversus: A Case Report

Kaur¹,

Kumar²

2019

Obstet Gynecol Cases Rev

View full text Add to dashboard Cite

Leiomyomas or fibroids are the most common benign tumor of uterus and it often increases in size during pregnancy. Its incidence in pregnancy is approximately 1.5-2% and is associated with increased risk of complication during pregnancy including abortions, preterm labor, red degeneration, malpresentations, increased cesarean section rates, postpartum hemorrhage. We hereby, discuss a case of large multi-lobed uterine fibroid complicating the second trimester of pregnancy. Our patient presented with a large leiomyoma of approximately 28 × 30 cm size at 28 weeks of gestation with acute red degeneration of fibroid with intracapsular and intra-peritoneal bleed. Life saving subtotal hysterectomy was done and around 1.5-2 liters of blood was drained out from the abdominal cavity. The total weight of uterus with fibroid was around 15 kg and benign leiomyoma was confirmed on histopathological examination.

show abstract

Uterine fibroid size modifications during pregnancy and puerperium: evidence from the first systematic review of literature

Cited by 82 publications

References 31 publications

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Uterine fibroids and preterm birth risk: A systematic review and meta‐analysis

A Rare Case of Large Uterine Myoma in an Antenatal Women with Situs Inversus: A Case Report

Contact Info

Product

Resources

About