Obstetric Outcomes in Women With Uterine Fibroids at Kenyatta National Hospital-a Prospective Cohort Study

Abstract

Background Uterine fibroids are the most common benign tumors in women, with an estimated prevalence of 0.1-4% in pregnancy. Prevalence rates vary with race, and are most common in Africanwomen. Uterine fibroids have been associated with adverse pregnancy outcomes such as preterm labour and delivery, preterm premature rupture of membranes, placental abruption, fetal malpresentation, postpartum hemorrhage, and high cesarean section rates. Despite the high prevalence of fibroids reported among African women, there is limited data on obstetric outcomes in pregnant women with fibroids.Previous studies done on the subject have reported inconsistent findings. Objective To determine the effect of uterine fibroids on obstetric outcomes from 28 weeks. Methods This was a prospective cohort study ofpregnant women who had routine obstetric ultrasonography by 28 weeks of gestation at Kenyatta National Hospital. Seventy onewomenwith uterine fibroids detected by ultrasonography and seventy two women without fibroids were followed up monthly until delivery. Maternal, fetal and early neonatal outcomes were recorded as the women progressed to delivery and compared between the two groups. Results Presence of fibroids was associated with advanced maternal age. No significant difference was observed between the two groups with regard to preterm premature rupture of membranes, preterm labour and delivery, small for gestational age infant, antepartum haemorrhage, mode of delivery, duration of labour, postpartum hemorrhage, fetal presentation and neonatal outcomes (p> 0.05). Conclusion Pregnant women with fibroids are not at an increased risk of adverse obstetric outcomes compared to women without fibroids.