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Leiomyomas in pregnancy: sonographic study.

A S Lev-Toaff, B G Coleman, P H Arger

    Radiology
    |August 1, 1987
    PubMed
    Summary
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    Ultrasound monitoring reveals uterine fibroid (leiomyoma) size changes during pregnancy. Degenerative changes in fibroids can indicate severe pain, and location impacts pregnancy outcomes.

    Area of Science:

    • Obstetrics and Gynecology
    • Medical Imaging
    • Reproductive Medicine

    Background:

    • Uterine leiomyomas (fibroids) are common benign tumors.
    • Their behavior and impact on pregnancy are not fully understood.
    • Ultrasound is a key tool for monitoring fibroids during gestation.

    Purpose of the Study:

    • To analyze uterine fibroid behavior during pregnancy using ultrasound.
    • To correlate fibroid characteristics with pregnancy complications.
    • To investigate fibroid size and echotexture changes throughout gestation.

    Main Methods:

    • Ultrasound monitoring of 113 pregnant patients with uterine fibroids.
    • Analysis of fibroid size changes by trimester.
    • Assessment of fibroid echotexture patterns.

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  • Correlation of fibroid characteristics with pregnancy outcomes and symptoms.

    • Main Results:

    • Smaller fibroids grew in the second trimester; larger ones shrank. All fibroids decreased in size by the third trimester.
    • Hypoechoic, heterogeneous, and echogenic rim were common echotextures.
    • New heterogeneous or anechoic/cystic spaces correlated with severe pain, suggesting degeneration.
    • Lower uterine segment fibroids increased C-section and retained placenta rates.
    • Uterine corpus fibroids were linked to early abortions.
    • Multiple fibroids were associated with malpresentation and premature contractions.

    Conclusions:

    • Fibroid behavior during pregnancy is dynamic, with size and echotexture changes occurring.
    • Specific echotexture changes may indicate fibroid degeneration and cause pain.
    • Fibroid location and number significantly influence pregnancy course and delivery outcomes.
    • Ultrasound is crucial for predicting and managing fibroid-related pregnancy complications.