This study was undertaken to evaluate the effect of myoma on pregnancy.
30 pregnant women whose myomas were detected prior to pregnancy or during the antenatal care(detected group) and 54 pregnant women whose myomas were not detected until delivery (undetected group) participated in this study at the Department of
Obstetrics and Gynecology, Ewha womans University Hospital from the Nov. 1987 to Oct. 1992. Clinical manifestations such as mode of diagnosis, size of myoma, outcome of pregnancy and complications were analyzed between the patients of these two
groups.
@ES The results were as follows:
@EN 1. Mean age of the patients in detected group and undetected group was 30.5 years and 30.2 years respectively. There was no difference in the proportion of primiparity(detected group: 83.3%, undetected group: 75.9%) land spontaneous abortion
in
the
past history (detected group: 23.4%, undetected group: 20.4%) between the two groups.
2. Uterine myoma was detected by clinical examination and ultrasonogram prior to pregnancy or during the antenatal care in the patients of detected group and incidentally at delivery in the patients of undetected group.
3. The most common type of uterine myomas was subserosal myoma in the two groups.
The proportion of intramural myoma was significantly higher in detected group than in undetected group, and subserosal myoma was more significantly higher in undetected group than in detected group. The most common location of uterine myoma was
the
anterior part of uterine corpus in the two groups and the proportion was not significantly different between the two groups.
4. Diameter 2 cm or more sized uterine myomas were detected by clinical examination and ultrasonogram and diameter 6 cm or more sized uterine myomas were detected in all during the antenatal care. Small myomas less than 2 cm in diameter were
detected
incidentally at delivery and the proportion was significantly higher in undetected group than in detected group. Multiple myomas were not significantly different in the proportion between the two groups.
5. Pregnancies with uterine myomas were ended to full term delivery, premature delivery and spontaneous abortion.
The proportion of full term delivery was significantly higher in undetected group than in detected group and spontaneous abortion was significantly higher in detected group than in undetected group.
6. There was premature labor, abnormal presentation, obstructed labor, and operative bleeding in obstetric complications.
The risks of premature labor and abnormal presentation were not significantly different between the two groups, but the risks of obstructed labor and operative bleeding were significantly higher in detected group than in undetected group.
Secondary pathologic changes in the myomectomy specimen were degeneration, necrosis, and cystic change land there was not significantly different in the proportion between the two groups.
|