Approximately 10-40% of women with fibroids during pregnancy experience complications associated with myomas. The incidence of myomas in pregnancy is increasing as more women delay child bearing, because age is an independent risk factor for the development of leiomyomata. Although the majority of pregnancies affected by fibroids are asymptomatic and uneventful, myomas clearly increase the risk of developing serious adverse outcomes which are outlined within this chapter. Currently, management of fibroid disease in pregnancy is heavily influenced by the severity of a patient's symptoms, and it is ultimately subjective to what physicians deem appropriate and safe for their patients. Furthermore, treatment guidelines often are not evidence based due to lack of larger randomized control studies on myomectomies during pregnancy and at time of cesarean. The associated benefits and risks of surgical management of fibroids throughout pregnancy and at parturition will be discussed in detail throughout the chapter and compared to conservative medical management.
- Fibroids in pregnancy
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