A Retrospective Study of Pregnancy Outcome with Uterine Fibroids - A Case Series

Abstract

Introduction: Uterine fibroids are the commonest benign uterine tumors in women of reproductive age and are increasingly encountered during pregnancy. Their presence may alter placentation, fetal lie, labor progress, and postpartum uterine contractility, thereby contributing to adverse maternal and perinatal outcomes. However, the clinical course varies according to fibroid size, number, and location.

Aim & Objective: To evaluate pregnancy outcomes in women with uterine fibroids and to assess associated maternal, fetal, intrapartum, postpartum, and perinatal complications in fibroid-complicated pregnancies.

Materials & Methods: This retrospective case series was conducted at a tertiary care centre, KIMS, Koppal, and included 9 pregnant women with uterine fibroids managed between January 2025 and June 2025. Data were collected from hospital case records and labor ward registers. Variables studied included maternal age, gravidity, conception type, abortion history, timing of fibroid diagnosis, fibroid size, site and number, indication for cesarean section, maternal and postpartum complications, birth weight, and NICU admission. Descriptive analysis was performed.

Results: Maternal age ranged from 24 to 34 years, with all women being multigravida. Conception was spontaneous in 7 cases and induced in 2. Fibroids were diagnosed antenatally in 6 cases, before conception in 2, and intraoperatively in 1. Sizes ranged from 3 to 12 cm, mostly single and subserosal. All patients underwent cesarean section. Complications included APH, hypertensive disorders, preterm labor, and malpresentation. Postpartum hemorrhage occurred in 4 cases, 7 required transfusion, and 3 neonates needed NICU admission.

Conclusion: Pregnancy with uterine fibroids was associated with considerable fetomaternal morbidity, particularly operative delivery, hemorrhagic complications, and selective adverse neonatal outcomes. Early diagnosis, close antenatal surveillance, and careful delivery planning are essential to improve outcomes.