Vol. 6, Issue 2, Part A (2024)

Uterine leiomyoma is one of the most frequent benign tumors of the female reproductive system. It develops from the smooth muscle of the uterus. It affects 20-40% of women, although the estimated incidence during pregnancy is 0.1-3.9%. This study aimed to evaluate the obstetrics outcomes of patients with uterine fibroids and their consequences. The present study is cross sectional study was conducted in obstetric department in the Tikrit Teaching Hospital, in Tikrit city, from 1st October 2023 to 30^th June 2024. A convenient sample of 50 pregnant women with uterine fibroid, at third trimester. Inclusion Criteria include pregnant women with a documented uterine fibroid diagnosed prenatally or antenatally, at reproductive age (18- 45 years), with any parity. Any Pregnant women with previous cesarean section, uterine or cervical surgery, Uterine Deformity, Chronic conditions such as hypertension and diabetes were excluded.

Data collected by direct interview with the pregnant women, taking information about sociodemographic variables, antenatal, Intrapartum, Postpartum history, number, size, and characteristics of fibroids. Ultrasonography to confirm gestational age, fetal growth restriction, fibroid location, and size were done. Verbal and written informed consent was obtained individually from all participants. Most of cases had single uterine fibroid 40(80%), followed by multiple fibroids 10(20%). Most of the fibroids were posteriorly located 33(66%), followed by anterior location 17(34%); located at the uterine body 32(64%), fundus 15(30%) and near the cervix 3(6%). Intramural found among 34(68%), subserosal 8(16%) and submucosal 8(16%). The uterine fibroid size was < 5 cm among 25(50%), 5-10 cm among 24(28%), and > 10 cm among 1(2%). Most of pregnant women had cesarean section 26(52%), spontaneous abortion found among 2(4%), History of early vaginal bleeding found among 2(4%), Malpresentation found among 14(28%), antepartum hemorrhage 11(22%), postpartum hemorrhage among 22(44%), abdominal pain needing admission found among 2(4%), blood transfusion found among 8(16%). The bad perinatal outcome was Apgar score ≤ 7 at 1 minute found among 13(26%), Apgar score ≤ 7 at 5 minutes 3(6%), Neonatal admission 10(20%), Low Birth weight 16(32%), Preterm Birth 7(14%). Blood transfusion significantly more common among those with fibroid 5-10 cm than < 5 cm; 8(33.3%), 0 (0%) respectively. No difference in obstetrical outcome found regarding difference in number of uterine fibroids. Low Birth weight 6(60%) was significantly associated with multiple fibroids. preterm Birth 4(16.7%) was significantly associated with the size of the uterine fibroid. Careful screening is needed for diagnosis of the uterine fibroid during pregnancy to decrease the unfavorable maternal and neonatal outcomes.