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Uterine Fibroids and Pregnancy: How Do They Affect Each Other?
Coutinho, Larissa M; Assis, Wiviane A; Spagnuolo-Souza, Ananda; Reis, Fernando M.
Afiliação
  • Coutinho LM; Department of Maternal and Child Health, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
  • Assis WA; Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
  • Spagnuolo-Souza A; Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
  • Reis FM; Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Reprod Sci ; 29(8): 2145-2151, 2022 08.
Article em En | MEDLINE | ID: mdl-34142343
The present narrative review is aimed to rekindle discussion regarding whether and how uterine leiomyoma and pregnancy may impact each other. Although fibroids are hormone-dependent lesions, their growth during pregnancy seems to have a nonlinear trend. Besides placental estrogens and progesterone, an array of endocrine and paracrine factors affect fibroid blood supply, growth rate, and risk of degeneration along the gestational and puerperal periods. According to current evidence, the presence of leiomyomas might increase the risk of some adverse pregnancy outcomes. Although a causative relation between fibroids and spontaneous abortion is questionable, the presence of multiple submucosal lesions in certain populations, such as infertile women, may increase the risk of pregnancy loss. Slightly increased risks of placenta previa, placental abruption and fetal malpresentation may occur, mainly due to the mechanical influence of multiple and large fibroids. Cesarean section and preterm birth rates are also probably increased in the presence of fibroids. The risk associations are based on meta-analyses of cohort studies (level of evidence 2a), retrospective cohort studies (2b), case-control (3a), and cross-sectional studies (3b), but with a predominantly low risk of bias. For evaluating the growth pattern of leiomyomas and their real influence on obstetric outcomes, future studies should enroll women with fibroids diagnosed prior to pregnancy and follow them prospectively throughout the gestation and puerperium.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Neoplásicas na Gravidez / Neoplasias Uterinas / Aborto Espontâneo / Nascimento Prematuro / Infertilidade Feminina / Leiomioma Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: Reprod Sci Assunto da revista: MEDICINA REPRODUTIVA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Neoplásicas na Gravidez / Neoplasias Uterinas / Aborto Espontâneo / Nascimento Prematuro / Infertilidade Feminina / Leiomioma Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: Reprod Sci Assunto da revista: MEDICINA REPRODUTIVA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos