Impaired delivery outcomes in pregnancies following myomectomy compared to myoma-complicated pregnancies.

ABSTRACT

OBJECTIVE: To compare obstetric and delivery outcomes between myoma-complicated pregnancies and pregnancies that follow myomectomy. STUDY DESIGN: Among the 7,589 deliveries performed in the Department of Obstetrics and Gynecology of the Osaka University Hospital, Osaka, Japan, from 1994 to 2007, women with a past history of myomectomy and those with myoma during their pregnancy were enrolled in this study. Their clinical records were reviewed retrospectively. RESULTS: The frequency of myomas detected during pregnancy significantly increased by 1.8-fold during the first 7-year period as compared with the latter 7-year period of the study (p < 0.001). The obstetric and delivery outcomes, including the rate of cesarean section, the rate of preterm delivery and the amount of blood loss at delivery, were better in pregnancies complicated with current myoma than those in pregnancies which had undergone previous myomectomy (p < 0.001, p = 0.002 and p = 0.005, respectively), with the exception of an increased need for analgesic medication. CONCLUSION: Myomectomy of large asymptomatic myomas does not improve future obstetric and delivery outcomes, indicating that most asymptomatic myomas should be managed conservatively in women still considering childbearing.