EFFECTS OF FIBROID ON PREGNANCY AND MODE OF DELIVERY
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Objective: To find the age wise prevalence in our patients and its effect on pregnancy in terms of fetal and maternal complication and also its effect on mode of delivery.
Material & Methods: Prospective observational study conducted in Department of Obstetrics and Gynaecology, Mardan
Medical Complex from March 2015 to March 2016. Data were recorded on proforma. Frequency and percentages were calculated for booking status parity, age and mode of delivery.
Results: Fifty-five patients out of 7109 (0.77% prevalence) obstetric admissions were included in the study. 48(87.27%) patients were booked while 7 (12.73%) patients were not booked. Fourteen (25.45%) patients had vaginal delivery, 31 (56.36%) patients had Ceaserian Section (C/S) 12 patients had emergency Ceaserian Section (C/S) and 19 patients had elective Ceaserian Section (C/S), 2 babies delivered by delee’s incision an done by classical incision. Primary dysfunctional labour (8,14.57%) and secondary arrest (4,7.27% ) and on fetal distress (8,14.5%) were the commonest indications for emergency cs. conception following a long period of sub fertility i.e, > 5 years (9,16.3%) and elderly primi gravid were the commonest indications of elective cs. 10(18.8%) patients had miscarriage. Fibroids were more common in first and second pregnancy. Only 6 (10.9%) were grand multigravida. Patient’s age ranged from 24 to 40 years and median age was 30 years. 30(54.54%) patients remained asymptomatic. 12 (21.81%) had bleeding in early pregnancy out of which 10 resulted in loss of pregnancy. 3(5.4%) patients had malpresentation. 3(5.4%) patients had pre term pre mature rupture of membranes. 6(10.9%) patients had technical difficulty during cesarean section. 8 (14.5%) patients had pain throughout pregnancy. 3 (5.4%) patients had primary post Partum Haemorrhage (PPH). Maternal mortality was nil. Three babies had intra uterine growth retardation. There was one in utero death and 2 early neonatal deaths.
Conclusion: Fibroids in pregnancy increase cesarean section rate due to delayed conception, primary dysfunctional labour, secondary arrest of labour and fetal distress. Size of fibroids generally increase in pregnancy. It is high risk pregnancy needs vigilant monitoring but usually the outcome is good. Anticipation and management of technical difficulties during cesarean section should be pre planned.
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