Cervical leiomyomas in pregnancy: report of 17 cases

To analyse the management strategies and delivery outcomes of women with cervical leiomyomas in pregnancy.

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.

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).

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.