Natural modification of uterine fibroids during pregnancy

doi:10.3969/j.issn.1006-7795.2021.01.016

Abstract

Abstract: Objective To explore the natural modification of uterine fibroids during pregnancy. Methods This longitudinal study enrolled a total of 499 cases of uterine fibroids during pregnancy in Beijing Chaoyang Hospital, Capital Medical University from January 1st 2011 to December 31st 2017. The fibroids' maximum diameter determined with ultrasound in different trimesters of pregnancy was extracted from medical record and analyzed respectively. Results A significant increase of uterine fibroids in diameter was observed from the first trimester to the second trimester of pregnancy [(3.94±2.02) cm vs (3.05±1.69)cm,t=13.94, P＜0.001)],and from the second trimester to early third trimester [(4.18±2.22) cm vs (4.02±2.23) cm,t=2.96,P=0.003)], while no significant change in size of fibroids was seen between the early and the late third trimester [(3.93±2.17) cm vs (3.91±2.15) cm,t=-0.81,P=0.417]. A progressive increase in the diameter of fibroids was detected from the first trimester to the late third trimesters [(2.94±1.70) cm vs (3.86±2.01) cm, t=-13.43,P<0.001]. However this kind of growth trend had proved to have no relation to the initial maximum diameter detected in the first trimester, patient age, obstetric history (gravidity, parity),location or number of fibroids (P＞0.05). In 175 cases with complete data (ultrasound results in 4 periods of pregnancy respectively), 38.3% of the maximum diameter of fibroids throughout pregnancy occurred in the second trimester, while 33.1% in the early third trimester, 21.1% in the late third trimester, and only 7.4% occurred in the first trimester. Taking both sensitivity and specificity into consideration, the maximum diameter of fibroid in the first trimester larger than 4 cm showed the most predictive value that the fibroids would be significantly enlarged during pregnancy (>3 cm), with a sensitivity of 83.33% and specificity of 76.07%. Conclusions There was a significant increase, also the largest increment in uterine fibroids during pregnancy from the first to the second trimester. The increase slowed down progressively in the early third trimester, followed by a subsequent decrease in the late third trimester. The growing trend of uterine fibroids with different initial sizes were similar to one another.

Key words: pregnancy, uterine fibroids, maximum diameter, natural modification

CLC Number:

R713

Zhao Jing, Luo Mei, Wang Shuzhen, Ding Ling, Zheng Jing. Natural modification of uterine fibroids during pregnancy[J]. Journal of Capital Medical University, 2021, 42(1): 94-100.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2021.01.016

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2021/V42/I1/94

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