Outcome of Pregnancy In Myomatous Uterus in the Gynecology-Obstetrics Department of the Ignace Deen Hospital of the Conakry University Hospital Centre, Guinea

Abstract

Introduction: the association of myoma and pregnancy is a frequent entity, often prone to obstetric complications. The aim of this study was to analyse the impact of myoma on pregnancy, childbirth and the post-partum period. Patients and methods: this was a prospective descriptive and analytical study conducted over a 6-month period from 6 September 2022 to 5 March 2023 in the gynaecology and obstetrics department of Ignace Deen Hospital. It concerned pregnant women with uterine myomas who had agreed to take part in the study. Results: the frequency of pregnancy in a myomatous uterus was 5.58%. The average age of the pregnant women was 28, with extremes of 21 and 40. The most common age group was 31-35. Nearly 70% (69.86%) of the cases of fibroids associated with pregnancy were discovered by ultrasound. The location of the myomas was interstitial in 47.95% of cases. Medium-sized fibroids (6-10 cm) dominated our series (53.42% of cases). Of the 146 cases collected, 72% gave birth in the department, 77.78% by caesarean section. The indication for caesarean section Dystocic presentations (54.76%) were the major indication in more than half the cases. Over 70% of pregnant women gave birth without complications. These were dominated in the mother by miscarriage (20.93%) and premature delivery (16.27%). Fetal asphyxia (4.65%) and intrauterine growth retardation (4.65%) in the fetus. The study reported a significant association between size, location and the occurrence of obstetric complications (P value: 0.034; 0.009). Conclusion: the association of fibroma and pregnancy is a frequent entity and constitutes a high risk for the mother and the foetus. Morbidity is related to the location of the myoma and changes according to the term of the pregnancy. If pregnancy is to have a successful outcome, it is essential that pregnant women are aware of the importance of antenatal monitoring, with a view to early detection and appropriate management of any complications.