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Fibroids in pregnancy: management and outcomes
Author(s) -
Sampat Karan,
Alleemudder Djavid I
Publication year - 2018
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1111/tog.12491
Subject(s) - medicine , placental abruption , uterine fibroids , pregnancy , caesarean section , hysterectomy , obstetrics , ulipristal acetate , uterine artery , uterine artery embolization , vaginal delivery , gynecology , fetus , surgery , population , family planning , gestation , genetics , environmental health , research methodology , biology
Key content In pregnancy, fibroids can lead to complications such as placental abruption and increased caesarean section rates. Surgical intervention of fibroids within the first two trimesters is possible in selected women. Increasing evidence suggests that myomectomy can be performed concurrently with caesarean section without an increased risk of blood transfusion or hysterectomy. Adverse outcomes are associated with subsequent pregnancies following uterine artery embolisation.Learning objectives To outline the complications of fibroids and treatment options in pregnancy. To determine pregnancy outcomes in those previously treated for uterine fibroids, including with uterine artery embolisation and ulipristal acetate. To discuss the mode of delivery in women with a previous myomectomy.Ethical issues With the provision of informed consent, should women with a previous myomectomy be encouraged to proceed with vaginal delivery? A greater rate of certain complications has been observed in pregnancies that follow uterine artery embolisation. Should this information be provided routinely?