Jishun Tian1, Wensheng Hu. 1. Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Abstract
AIM: To analyse the management strategies and delivery outcomes of women with cervical leiomyomas in pregnancy. METHODS: We retrospectively analysed the pregnancy outcomes of 17 women with cervical leiomyomas. The outcome measures assessed included the volume of blood loss at delivery, need for blood transfusion, intra- and post-operative complications and length of hospital stay. RESULTS: The mean diameter of the leiomyomas was 10.4 ± 7.2 cm, with a range of 3-30 cm. The mean blood loss was 697 ± 394 mL (range of 350-4200 mL). Six women (35.3%) required a blood transfusion. The mean duration of stay in hospital after delivery was 7.9 ± 3.9 days (range 4-20 days). There were three cases of severe haemorrhage or infection post-operation necessitating hysterectomy, and all of the leiomyomas in these cases were more than 20 cm in diameter. There was a positive correlation between the blood loss volume and the size of leiomyomas (correlation coefficient 0.638, P < 0.01). CONCLUSIONS: The dimensions of cervical leiomyomas influences post-partum blood loss. Large cervical leiomyomas appear associated with adverse outcomes. When the leiomyomas are relatively small, an experienced practitioner could consider myomectomy during a caesarean delivery.
AIM: To analyse the management strategies and delivery outcomes of women with cervical leiomyomas in pregnancy. METHODS: We retrospectively analysed the pregnancy outcomes of 17 women with cervical leiomyomas. The outcome measures assessed included the volume of blood loss at delivery, need for blood transfusion, intra- and post-operative complications and length of hospital stay. RESULTS: The mean diameter of the leiomyomas was 10.4 ± 7.2 cm, with a range of 3-30 cm. The mean blood loss was 697 ± 394 mL (range of 350-4200 mL). Six women (35.3%) required a blood transfusion. The mean duration of stay in hospital after delivery was 7.9 ± 3.9 days (range 4-20 days). There were three cases of severe haemorrhage or infection post-operation necessitating hysterectomy, and all of the leiomyomas in these cases were more than 20 cm in diameter. There was a positive correlation between the blood loss volume and the size of leiomyomas (correlation coefficient 0.638, P < 0.01). CONCLUSIONS: The dimensions of cervical leiomyomas influences post-partum blood loss. Large cervical leiomyomas appear associated with adverse outcomes. When the leiomyomas are relatively small, an experienced practitioner could consider myomectomy during a caesarean delivery.