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Minerva Obstetrics and Gynecology 2021 May 14

DOI: 10.23736/S2724-606X.21.04676-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Myomectomy during pregnancy: an obstetric overview and two case-series

Giuseppe LOVERRO 1, Gianluca R. DAMIANI 2 , Antonio MALVASI 1, Matteo LOVERRO 1, Luca M. SCHONAUER 1, Giuseppe MUZZUPAPA 1, Edoardo DINARO 1

1 Department of Obstetrics and Gynecology, University of Bari, Bari, Italy; 2 Department of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic, Bari, Italy


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INTRODUCTION: Uterine fibroids (UFs) are the most common benign disease affecting female reproductive system, occur in 20-40 % of women, and in 10 % of pregnancies. The aim of the investigation was to summarize evidences about the management and treatment of UFs and related complications in pregnancy.
MATERIALS AND METHODS: A literature review was performed using scientific databases, including all case report and case series, using a combination of key words relating to the problem exposed. Data about gestational age at diagnosis, maximum fibroids diameter, type of surgery and gestational age at surgery, delivery and perinatal outcome were collected. Two clinical cases were also included.
RESULTS: Sixty-six articles were selected and 199 patients were included. In 76 % of patients the gestational age at myomectomy was lower than 20 weeks, in 85 % laparotomic surgery was chosen, in 41 % of cases the maximum fibroid diameter was between 7-20 cm, in 41 % of pregnancies the route of delivery was cesarean section. The eight percent of cases was complicated by miscarriage or fetal demise or neonatal death.
CONCLUSIONS: Myomectomy is a feasible procedure in those pregnancies complicated by symptomatic fibroids, though surgery in pregnancy is associated with an increased risk of obstetric complications.


KEY WORDS: Uterine fibroids; Myoma; Pregnancy; Cesarean section; Pseudocapsule; Delivery; Complications

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