Obstetric outcomes in women with sonographically identified uterine leiomyomata

G. Iram Qidwai, Aaron Caughey, Alison F. Jacoby

Research output: Contribution to journalArticle

132 Citations (Scopus)

Abstract

OBJECTIVE: To examine the association between leiomyomata and complications during pregnancy, delivery, and the puerperium. METHODS: We conducted a retrospective cohort study comparing pregnancy outcomes in women with and without uterine leiomyomata who underwent routine second trimester obstetric ultrasonography and delivered viable infants at a single institution. Potential confounding variables, including maternal age, weight, ethnicity, parity, gestational age, epidural use, and labor induction, were controlled for using multivariate logistic regression techniques. RESULTS: From 1993 to 2003, 15,104 women underwent routine second trimester prenatal ultrasonography, and 401 (2.7%) women were identified with at least 1 leiomyoma. By univariate and multivariate analyses, the presence of leiomyomata was associated with increased risks for cesarean delivery (adjusted odds ratio [AOR] 1.57, 95% confidence interval [CI] 1.16-2.13), breech presentation (AOR 1.64, 95% CI 1.11-2.40), malposition (AOR 1.59, 95% CI 1.18-2.15), preterm delivery (AOR 1.45, 95% CI 1.08-1.96), placenta previa (AOR 1.86, 95% CI 1.02-3.39), and severe postpartum hemorrhage (AOR 2.57, 95% CI 1.54-4.27). Premature rupture of membranes, operative vaginal delivery, chorioamnionitis, and endomyometritis were not associated with leiomyomata. Median length of labor was not different between the 2 groups. When compared with leiomyomata less than 10 cm in size, leiomyomata 10 cm or larger were associated with rates of cesarean delivery that were not statistically different (25% compared with 31%, P = .49). CONCLUSION: Pregnant women with leiomyomata are at increased risk for cesarean delivery, breech presentation, malposition, preterm delivery, placenta previa, and severe post partum hemorrhage. Women with leiomyomata 10 cm or larger achieve a vaginal delivery rate of nearly 70%. These results are useful for preconception and prenatal counseling of women with leiomyomata.

Original languageEnglish (US)
Pages (from-to)376-382
Number of pages7
JournalObstetrics and Gynecology
Volume107
Issue number2 I
DOIs
StatePublished - Feb 2006
Externally publishedYes

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Leiomyoma
Obstetrics
Odds Ratio
Confidence Intervals
Breech Presentation
Placenta Previa
Second Pregnancy Trimester
Prenatal Ultrasonography
Induced Labor
Chorioamnionitis
Endometritis
Postpartum Hemorrhage
Confounding Factors (Epidemiology)
Pregnancy Complications
Maternal Age
Pregnancy Outcome
Parity
Postpartum Period
Gestational Age
Counseling

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Obstetric outcomes in women with sonographically identified uterine leiomyomata. / Qidwai, G. Iram; Caughey, Aaron; Jacoby, Alison F.

In: Obstetrics and Gynecology, Vol. 107, No. 2 I, 02.2006, p. 376-382.

Research output: Contribution to journalArticle

Qidwai, G. Iram ; Caughey, Aaron ; Jacoby, Alison F. / Obstetric outcomes in women with sonographically identified uterine leiomyomata. In: Obstetrics and Gynecology. 2006 ; Vol. 107, No. 2 I. pp. 376-382.
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abstract = "OBJECTIVE: To examine the association between leiomyomata and complications during pregnancy, delivery, and the puerperium. METHODS: We conducted a retrospective cohort study comparing pregnancy outcomes in women with and without uterine leiomyomata who underwent routine second trimester obstetric ultrasonography and delivered viable infants at a single institution. Potential confounding variables, including maternal age, weight, ethnicity, parity, gestational age, epidural use, and labor induction, were controlled for using multivariate logistic regression techniques. RESULTS: From 1993 to 2003, 15,104 women underwent routine second trimester prenatal ultrasonography, and 401 (2.7{\%}) women were identified with at least 1 leiomyoma. By univariate and multivariate analyses, the presence of leiomyomata was associated with increased risks for cesarean delivery (adjusted odds ratio [AOR] 1.57, 95{\%} confidence interval [CI] 1.16-2.13), breech presentation (AOR 1.64, 95{\%} CI 1.11-2.40), malposition (AOR 1.59, 95{\%} CI 1.18-2.15), preterm delivery (AOR 1.45, 95{\%} CI 1.08-1.96), placenta previa (AOR 1.86, 95{\%} CI 1.02-3.39), and severe postpartum hemorrhage (AOR 2.57, 95{\%} CI 1.54-4.27). Premature rupture of membranes, operative vaginal delivery, chorioamnionitis, and endomyometritis were not associated with leiomyomata. Median length of labor was not different between the 2 groups. When compared with leiomyomata less than 10 cm in size, leiomyomata 10 cm or larger were associated with rates of cesarean delivery that were not statistically different (25{\%} compared with 31{\%}, P = .49). CONCLUSION: Pregnant women with leiomyomata are at increased risk for cesarean delivery, breech presentation, malposition, preterm delivery, placenta previa, and severe post partum hemorrhage. Women with leiomyomata 10 cm or larger achieve a vaginal delivery rate of nearly 70{\%}. These results are useful for preconception and prenatal counseling of women with leiomyomata.",
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N2 - OBJECTIVE: To examine the association between leiomyomata and complications during pregnancy, delivery, and the puerperium. METHODS: We conducted a retrospective cohort study comparing pregnancy outcomes in women with and without uterine leiomyomata who underwent routine second trimester obstetric ultrasonography and delivered viable infants at a single institution. Potential confounding variables, including maternal age, weight, ethnicity, parity, gestational age, epidural use, and labor induction, were controlled for using multivariate logistic regression techniques. RESULTS: From 1993 to 2003, 15,104 women underwent routine second trimester prenatal ultrasonography, and 401 (2.7%) women were identified with at least 1 leiomyoma. By univariate and multivariate analyses, the presence of leiomyomata was associated with increased risks for cesarean delivery (adjusted odds ratio [AOR] 1.57, 95% confidence interval [CI] 1.16-2.13), breech presentation (AOR 1.64, 95% CI 1.11-2.40), malposition (AOR 1.59, 95% CI 1.18-2.15), preterm delivery (AOR 1.45, 95% CI 1.08-1.96), placenta previa (AOR 1.86, 95% CI 1.02-3.39), and severe postpartum hemorrhage (AOR 2.57, 95% CI 1.54-4.27). Premature rupture of membranes, operative vaginal delivery, chorioamnionitis, and endomyometritis were not associated with leiomyomata. Median length of labor was not different between the 2 groups. When compared with leiomyomata less than 10 cm in size, leiomyomata 10 cm or larger were associated with rates of cesarean delivery that were not statistically different (25% compared with 31%, P = .49). CONCLUSION: Pregnant women with leiomyomata are at increased risk for cesarean delivery, breech presentation, malposition, preterm delivery, placenta previa, and severe post partum hemorrhage. Women with leiomyomata 10 cm or larger achieve a vaginal delivery rate of nearly 70%. These results are useful for preconception and prenatal counseling of women with leiomyomata.

AB - OBJECTIVE: To examine the association between leiomyomata and complications during pregnancy, delivery, and the puerperium. METHODS: We conducted a retrospective cohort study comparing pregnancy outcomes in women with and without uterine leiomyomata who underwent routine second trimester obstetric ultrasonography and delivered viable infants at a single institution. Potential confounding variables, including maternal age, weight, ethnicity, parity, gestational age, epidural use, and labor induction, were controlled for using multivariate logistic regression techniques. RESULTS: From 1993 to 2003, 15,104 women underwent routine second trimester prenatal ultrasonography, and 401 (2.7%) women were identified with at least 1 leiomyoma. By univariate and multivariate analyses, the presence of leiomyomata was associated with increased risks for cesarean delivery (adjusted odds ratio [AOR] 1.57, 95% confidence interval [CI] 1.16-2.13), breech presentation (AOR 1.64, 95% CI 1.11-2.40), malposition (AOR 1.59, 95% CI 1.18-2.15), preterm delivery (AOR 1.45, 95% CI 1.08-1.96), placenta previa (AOR 1.86, 95% CI 1.02-3.39), and severe postpartum hemorrhage (AOR 2.57, 95% CI 1.54-4.27). Premature rupture of membranes, operative vaginal delivery, chorioamnionitis, and endomyometritis were not associated with leiomyomata. Median length of labor was not different between the 2 groups. When compared with leiomyomata less than 10 cm in size, leiomyomata 10 cm or larger were associated with rates of cesarean delivery that were not statistically different (25% compared with 31%, P = .49). CONCLUSION: Pregnant women with leiomyomata are at increased risk for cesarean delivery, breech presentation, malposition, preterm delivery, placenta previa, and severe post partum hemorrhage. Women with leiomyomata 10 cm or larger achieve a vaginal delivery rate of nearly 70%. These results are useful for preconception and prenatal counseling of women with leiomyomata.

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