Skip to main content
SpringerLink
Log in
Book cover

Uterine Myoma, Myomectomy and Minimally Invasive Treatments pp 219–236Cite as

Myoma in Pregnancy

  • Chapter
  • First Online:

Abstract

Uterine myomas (leiomyomas or fibroids) are common benign tumors, arising from the smooth muscle of the uterus. The true prevalence of fibroids is unknown as there is no screening program for asymptomatic women, but the estimated prevalence of myomas is 30 % in all women, 20–40 % in reproductive aged women and 40–60 % of women by age 35 [1]. The risk of myoma increases significantly with increasing age, and by age 50, 70–80 % of women will have had a fibroid [2]. Prevalence is two to three times higher in black women [3]. Decreased incidence is observed with increased parity. This effect is further amplified with childbearing from age 25 to 29 [1]. Factors that alter estrogen levels also modify risk. Smoking, exercise, and lean body mass decrease the incidence, while obesity and early menarche increases the risk. Despite strong associations with estrogen, there is no observed effect with oral contraceptives (Fig. 15.1) [1, 3]. Myomas are typically classified as one of three types: subserous, intramural or submucous, determined by location relative to the myometrium. Further descriptors include pedunculated, for those attached by a stalk, or cervical, based on location (Fig. 15.2).

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007;87(4):725–36.

    Article  PubMed  Google Scholar 

  2. Bulun SE. Uterine fibroids. N Engl J Med. 2013;369(14):1344–55.

    Article  CAS  PubMed  Google Scholar 

  3. Zaima A, Ash A. Fibroid in pregnancy: characteristics, complications, and management. Postgrad Med J. 2011;87(1034):819–28.

    Article  PubMed  Google Scholar 

  4. Hasan F, Arumugam K, Sivanesaratnam V. Uterine leiomyomata in pregnancy. Int J Gynaecol Obstet. 1991;34(1):45–8.

    Article  CAS  PubMed  Google Scholar 

  5. Stout MJ, Odibo AO, Graseck AS, Macones GA, Crane JP, Cahill AG. Leiomyomas at routine second-trimester ultrasound examination and adverse obstetric outcomes. Obstet Gynecol. 2010;116(5):1056–63.

    Article  PubMed  Google Scholar 

  6. Donnez J, Jadoul P. What are the implications of myomas on fertility? A need for a debate? Hum Reprod. 2002;17:1424.

    Article  CAS  PubMed  Google Scholar 

  7. Practice Committee of the American Society for Reproductive Medicine. Myomas and reproductive function. Fertil Steril. 2008;90 Suppl 5:125.

    Google Scholar 

  8. Benecke C, Kruger TF, Siebert TI, Van der Merwe JP, Steyn DW. Effect of fibroids on fertility in patients undergoing assisted reproduction. A structured literature review. Gynecol Obstet Invest. 2005;59:225.

    Article  CAS  PubMed  Google Scholar 

  9. Somigliana E, Vercellini P, Daguati R, Pasin R, De Giorgi O, Crosignani PG. Fibroids and female reproduction: a critical analysis of the evidence. Hum Reprod Update. 2007;13:465.

    Article  CAS  PubMed  Google Scholar 

  10. Klatsky PC, Tran ND, Caughey AB, Fujimoto VY. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstet Gynecol. 2008;198:357–66.

    Article  PubMed  Google Scholar 

  11. Pritts EA, Parker WH, Olive DL. Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril. 2009;91:1215.

    Article  PubMed  Google Scholar 

  12. Pritts EA. Fibroids and infertility: a systematic review of the evidence. Obstet Gynecol Surv. 2001;56:483.

    Article  CAS  PubMed  Google Scholar 

  13. Farhi J, Ashkenazi J, Feldberg D, Dicker D, Orvieto R, Ben Rafael Z. Effect of uterine leiomyomata on the results of in-vitro fertilization treatment. Hum Reprod. 1995;10:2576.

    Article  CAS  PubMed  Google Scholar 

  14. Dietterich C, Check JH, Choe JK, Nazari A, Fox F. The presence of small uterine fibroids not distorting the endometrial cavity does not adversely affect conception outcome following embryo transfer in older recipients. Clin Exp Obstet Gynecol. 2000;27:168.

    CAS  PubMed  Google Scholar 

  15. Jun SH, Ginsburg ES, Racowsky C, Wise LA, Hornstein MD. Uterine leiomyomas and their effect on in vitro fertilization outcome: a retrospective study. J Assist Reprod Genet. 2001;18:139.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Surrey ES, Lietz AK, Schoolcraft WB. Impact of intramural leiomyomata in patients with a normal endometrial cavity on in vitro fertilization-embryo transfer cycle outcome. Fertil Steril. 2001;75:405.

    Article  CAS  PubMed  Google Scholar 

  17. Check JH, Choe JK, Lee G, Dietterich C. The effect on IVF outcome of small intramural fi broids not compressing the uterine cavity as determined by a prospective matched control study. Hum Reprod. 2002;17:1244.

    Article  CAS  PubMed  Google Scholar 

  18. Oliveira FG, Abdelmassih VG, Diamond MP, Dozortsev D, Melo NR, Abdelmassih R. Impact of subserosal and intramural uterine fibroids that do not distort the endometrial cavity on the outcome of in vitro fertilization-intracytoplasmic sperm injection. Fertil Steril. 2004;81:582.

    Article  PubMed  Google Scholar 

  19. Eldar-Geva T, Meagher S, Healy DL, MacLachlan V, Breheny S, Wood C. Effect of intramural, subserosal, and submucosal uterine fibroids on the outcome of assisted reproductive technology treatment. Fertil Steril. 1998;70:687.

    Article  CAS  PubMed  Google Scholar 

  20. Stovall DW, Parrish SB, Van Voorhis BJ, Hahn SJ, Sparks AE, Syrop CH. Uterine leiomyomas reduce the efficacy of assisted reproduction cycles: results of a matched follow-up study. Hum Reprod. 1998;13:192.

    Article  CAS  PubMed  Google Scholar 

  21. Casini ML, Rossi F, Agostini R, Unfer V. Effects of the position of fibroids on fertility. Gynecol Endocrinol. 2006;22:106.

    Article  PubMed  Google Scholar 

  22. Bulletti C, Ziegler DE, Levi Setti P, Cicinelli E, Polli V, Stefanetti M. Myomas, pregnancy outcome, and in vitro fertilization. Ann N Y Acad Sci. 2004;1034:84.

    Article  PubMed  Google Scholar 

  23. Vercellini P, Maddalena S, De Giorgi O, Pesole A, Ferrari L, Crosignani PG. Determinants of reproductive outcome after abdominal myomectomy for infertility. Fertil Steril. 1999;72:109.

    Article  CAS  PubMed  Google Scholar 

  24. Fauconnier A, Dubuisson JB, Ancel PY, Chapron C. Prognostic factors of reproductive outcome after myomectomy in infertile patients. Hum Reprod. 2000;15:1751.

    Article  CAS  PubMed  Google Scholar 

  25. Barakat EE, Bedaiwy MA, Zimberg S, Nutter B, Nosseir M, Falcone T. Robotic-assisted, laparoscopic, and abdominal myomectomy: a comparison of surgical outcomes. Obstet Gynecol. 2011;117:256–65.

    Article  PubMed  Google Scholar 

  26. Palomba S, Zupi E, Falbo A, Russo T, Marconi D, Tolino A, et al. A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: reproductive outcomes. Fertil Steril. 2007;88:933.

    Article  PubMed  Google Scholar 

  27. Holloway RW, Patel SD, Ahmad S. Robotic surgery in gynecology. Scand J Surg. 2009;98:96.

    CAS  PubMed  Google Scholar 

  28. Luciano AA. Myomectomy. Clin Obstet Gynecol. 2009;52:362.

    Article  PubMed  Google Scholar 

  29. Muram D, Gillieson M, Walters JH. Myomas of the uterus in pregnancy: ultrasonographic follow-up. Am J Obstet Gynecol. 1980;138:16–9.

    CAS  PubMed  Google Scholar 

  30. Karasick S, Lev-Toaff AS, Toaff ME. Imaging of uterine leiomyomas. AJR Am J Roentgenol. 1992;158:799–805.

    Article  CAS  PubMed  Google Scholar 

  31. Marcotte-Bloch C, Novellas S, Buratti MS, Caramella T, Chevallier P, Bruneton JN. Torsion of a uterine leiomyoma: MRI features. Clin Imaging. 2007;31(5):360–2.

    Article  PubMed  Google Scholar 

  32. Neiger R, Sonek JD, Croom CS, Ventolini G. Pregnancy-related changes in the size of uterine leiomyomas. J Reprod Med. 2006;51(9):671–4.

    PubMed  Google Scholar 

  33. Rosati P, Exacoustos C, Mancuso S. Longitudinal evaluation of uterine myoma growth during pregnancy. A sonographic study. J Ultrasound Med. 1992;11(10):511–5.

    CAS  PubMed  Google Scholar 

  34. Aharoni A, Reiter A, Golan D, Paltiely Y, Sharf M. Patterns of growth of uterine leiomyomas during pregnancy. A prospective longitudinal study. Br J Obstet Gynaecol. 1988;95(5):510–3.

    Article  CAS  PubMed  Google Scholar 

  35. Laughlin SK, Herring AH, Savitz DA, Olshan AF, Fielding JR, Hartmann KE, et al. Pregnancy-related fibroid reduction. Fertil Steril. 2010;94(6):2421–3.

    Article  PubMed Central  PubMed  Google Scholar 

  36. De Vivo A, Mancuso A, Giacobbe A, Savasta LM, De Dominici R, Dugo N, Dugo C, Vaiarelli A. Uterine myomas during pregnancy: a longitudinal sonographic study. Ultrasound Obstet Gynecol. 2011;37(3):361–5.

    Article  PubMed  Google Scholar 

  37. Hammoud AO, Asaad R, Berman J, Treadwell MC, Blackwell S, Diamond MP. Volume change of uterine myomas during pregnancy: do myomas really grow? J Minim Invasive Gynecol. 2006;13(5):386–90.

    Article  PubMed  Google Scholar 

  38. Lev-Toaff AS, Coleman BG, Arger PH, Mintz MC, Arenson RL, Toaff ME. Leiomyomas in pregnancy: sonographic study. Radiology. 1987;164(2):375–80.

    Article  CAS  PubMed  Google Scholar 

  39. Ouyang DW, Economy KE, Norwitz ER. Obstetric complications of fibroids. Obstet Gynecol Clin North Am. 2006;33(1):153–69.

    Article  PubMed  Google Scholar 

  40. Vollenhoven BJ, Lawrence AS, Healy DL. Uterine fibroids: a clinical review. Br J Obstet Gynaecol. 1990;97:285.

    Article  CAS  PubMed  Google Scholar 

  41. Buttram VC, Reiter RC. Uterine leiomyomata: etiology, symptomatology and management. Fertil Steril. 1981;36:433.

    PubMed  Google Scholar 

  42. Li TC, Mortimer R, Cooke ID. Myomectomy: a retrospective study to examine reproductive performance before and after surgery. Hum Reprod. 1999;14:1735–40.

    Article  CAS  PubMed  Google Scholar 

  43. Ramzy AM, Sattar M, Amin Y, Mansour RT, Serour GI, Aboulghar MA. Uterine myomata and outcome of assisted reproduction. Hum Reprod. 1998;13:198.

    Article  CAS  PubMed  Google Scholar 

  44. Goldenberg M, Sivan E, Sharabi Z, Bider D, Rabinovici J, Seidman DS. Outcome of hysteroscopic resection of submucous myomas for infertility. Fertil Steril. 1995;64:714.

    CAS  PubMed  Google Scholar 

  45. Giatras K, Berkeley AS, Noyes N, Licciardi F, Lolis D, Grifo JA. Fertility after hysteroscopic resection of submucous myomas. J Am Assoc Gynecol Laparosc. 1999;6:155.

    Article  CAS  PubMed  Google Scholar 

  46. Varasteh NN, Neuwirth RS, Levin B, Keltz MD. Pregnancy rates after hysteroscopic polypectomy and myomectomy in infertile women. Obstet Gynecol. 1999;94:168.

    Article  CAS  PubMed  Google Scholar 

  47. Fernandez H, Sefrioui O, Virelizier C, Gervaise A, Gomel V, Frydman R. Hysteroscopic resection of submucosal myomas in patients with infertility. Hum Reprod. 2001;16:1489.

    Article  CAS  PubMed  Google Scholar 

  48. Devi Wold AS, Pham N, Arici A. Anatomic factors in recurrent pregnancy loss. Semin Reprod Med. 2006;24(1):25–32.

    Article  PubMed  Google Scholar 

  49. Qidwai GI, Caughey AB, Jacoby AF. Obstetric outcomes in women with sonographically identified uterine leiomyomata. Obstet Gynecol. 2006;107(2 Pt 1):376–82.

    Article  PubMed  Google Scholar 

  50. Shavell VI, Thakur M, Sawant A, Kruger ML, Jones TB, Singh M, et al. Adverse obstetric outcomes associated with sonographically identified large uterine fibroids. Fertil Steril. 2012;97(1):107–10.

    Article  PubMed  Google Scholar 

  51. Chen YH, Lin HC, Chen SF, Lin HC. Increased risk of preterm births among women with uterine leiomyoma: a nationwide population-based study. Hum Reprod. 2009;24(12):3049–56.

    Article  PubMed  Google Scholar 

  52. Vergani P, Ghidini A, Strobelt N, Roncaglia N, Locatelli A, Lapinski RH, et al. Do uterine leiomyomas influence pregnancy outcome? Am J Perinatol. 1994;11(5):356–8.

    Article  CAS  PubMed  Google Scholar 

  53. Katz VL, Dotters DJ, Droegemueller W. Complications of uterine leiomyomas in pregnancy. Obstet Gynecol. 1989;73:593–6.

    CAS  PubMed  Google Scholar 

  54. De Carolis S, Fatigante G, Ferrazzani S, et al. Uterine myomectomy in pregnant women. Fetal Diagn Ther. 2001;16:116–9.

    Article  PubMed  Google Scholar 

  55. Norton ME, Merril J, Cooper BA, et al. Neonatal complications after administration of indomethacin for preterm labor. N Engl J Med. 1993;329:1602–7.

    Article  CAS  PubMed  Google Scholar 

  56. Seki H, Takizawa Y, Sodemoto T. Epidural analgesia for painful myomas refractory to medical therapy during pregnancy. Int J Gynaecol Obstet. 2003;83:303–4.

    Article  CAS  PubMed  Google Scholar 

  57. Falcone T, Parker WH. Surgical management of leiomyomas for fertility or uterine preservation. Obstet Gynecol. 2013;121:856–68.

    Article  PubMed  Google Scholar 

  58. Burton CA, Grimes DA, March CM. Surgical management of leiomyomata during pregnancy. Obstet Gynecol. 1989;74(5):707–9.

    CAS  PubMed  Google Scholar 

  59. Makar AP, Schatteman EA, Vergote IB, Desmedt E. Myomectomy during pregnancy: uncommon case report. Acta Chir Belg. 1989;89(4):212–4.

    CAS  PubMed  Google Scholar 

  60. Foissac R, Sautot-Vial N, Birtwisle L, et al. Torsion of a huge pedunculated uterine leiomyoma. Am J Surg. 2011;201(6):e43–5.

    Article  PubMed  Google Scholar 

  61. Leach K, Khatain L, Tocce K. First trimester myomectomy as an alternative to termination of pregnancy in a woman with a symptomatic uterine leiomyoma: a case report. J Med Case Reports. 2011;5(1):571.

    Article  PubMed Central  Google Scholar 

  62. Ardovino M, Ardovino I, Castaldi MA, Monteverde A, Colacurci N, Cobellis L. Laparoscopic myomectomy of a subserous pedunculated fibroid at 14 weeks of pregnancy: a case report. J Med Case Reports. 2011;5(1):545.

    Article  PubMed Central  Google Scholar 

  63. Fanfani F, Rossitto C, Fagotti A, Rosati P, Gallotta V, Scambia G. Laparoscopic myomectomy at 25 weeks of pregnancy: case report. J Minim Invasive Gynecol. 2010;17(1):91–3.

    Article  PubMed  Google Scholar 

  64. Pelosi MA, Pelosi 3rd MA, Giblin S. Laparoscopic removal of a 1500-g symptomatic myoma during the second trimester of pregnancy. J Am Assoc Gynecol Laparosc. 1995;2(4):457–62.

    Article  CAS  PubMed  Google Scholar 

  65. Son CE, Choi JS, Lee JH, Jeon SW, Bae JW, Seo SS. A case of laparoscopic myomectomy performed during pregnancy for subserosal uterine myoma. J Obstet Gynaecol. 2011;31(2):180–1.

    Article  CAS  PubMed  Google Scholar 

  66. Currie A, Bradley E, McEwen M, Al-Shabibi N, Willson PD. Laparoscopic approach to fibroid torsion presenting as an acute abdomen in pregnancy. JSLS. 2013;17(4):665–7.

    Article  PubMed Central  PubMed  Google Scholar 

  67. Sentilhes L, Sergent F, Verspyck E, Gravier A, Roman H, Marpeau L. Laparoscopic myomectomy during pregnancy resulting in septic necrosis of the myometrium. BJOG. 2003;110(9):876–8.

    Article  CAS  PubMed  Google Scholar 

  68. Walsh CA, Tang T, Walsh SR. Laparoscopic versus open appendectomy in pregnancy: a systematic review. Int J Surg. 2008;6(4):339–44.

    Article  PubMed  Google Scholar 

  69. Devlieger R, Millar LK, Bryant-Greenwood G, Lewi L, Deprest JA. Fetal membrane healing after spontaneous and iatrogenic membrane rupture: a review of current evidence. Am J Obstet Gynecol. 2006;195(6):1512–20.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  70. Friedman JD, Ramsey PS, Ramin KD, Berry C. Pneumoamnion and pregnancy loss after second-trimester laparoscopic surgery. Obstet Gynecol. 2002;99(3):512–3.

    Article  PubMed  Google Scholar 

  71. Walsh TM, Borahay MA, Fox KA, Kilic GS. Robotic-assisted, ultrasound-guided abdominal cerclage during pregnancy: overcoming minimally invasive surgery limitations? J Minim Invasive Gynecol. 2013;20(3):398–400.

    Article  PubMed  Google Scholar 

  72. Lee HJ, Norwitz ER, Shaw J. Contemporary management of fibroids in pregnancy. Rev Obstet Gynecol. 2010;3(1):20–7.

    PubMed Central  PubMed  Google Scholar 

  73. Lieng M, Istre O, Langebrekke A. Uterine rupture after laparoscopic myomectomy. J Am Assoc Gynecol Laparosc. 2004;11:92.

    Article  PubMed  Google Scholar 

  74. Banas T, Klimek M, Fugiel A, Skotniczny K. Spontaneous uterine rupture at 35 weeks’ gestation, 3 years after laparoscopic myomectomy, without signs of fetal distress. J Obstet Gynaecol Res. 2005;31:527.

    Article  PubMed  Google Scholar 

  75. Grande N, Catalano GF, Ferrari S, Marana R. Spontaneous uterine rupture at 27 weeks of pregnancy after laparoscopic myomectomy. J Minim Invasive Gynecol. 2005;12:301.

    Article  PubMed  Google Scholar 

  76. Parker WH, Iacampo K, Long T. Uterine rupture after laparoscopic removal of a pedunculated myoma. J Minim Invasive Gynecol. 2007;14:362.

    Article  PubMed  Google Scholar 

  77. Gyamfi-Bannerman C, Gilbert S, Landon MB, Spong CY, Rouse DJ, Varner MW, et al.; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Risk of uterine rupture and placenta accreta with prior uterine surgery outside of the lower segment. Obstet Gynecol. 2012;120(6):1332–7.

    Google Scholar 

  78. Cela V, Freschi L, Simi G, Tana R, Russo N, Artini PG, Pluchino N. Fertility and endocrine outcome after robot-assisted laparoscopic myomectomy (RALM). Gynecol Endocrinol. 2013;29(1):79–82.

    Article  CAS  PubMed  Google Scholar 

  79. Kim MS, Uhm YK, Kim JY, Jee BC, Kim YB. Obstetric outcomes after uterine myomectomy: Laparoscopic versus laparotomic approach. Obstet Gynecol Sci. 2013;56(6):375–81.

    Article  PubMed Central  PubMed  Google Scholar 

  80. Dubuisso JB, Fauconnier A, Babaki-Fard K, Chapron C. Laparoscopic myomectomy: a current view. Hum Reprod Update. 2000;6(6):588–94.

    Article  CAS  PubMed  Google Scholar 

  81. Pitter MC, Gargiulo AR, Bonaventura LM, Lehman JS, Srouji SS. Pregnancy outcomes following robot-assisted myomectomy. Hum Reprod. 2013;28(1):99–108.

    Article  PubMed  Google Scholar 

  82. Litta P, Conte L, De Marchi F, Saccardi C, Angioni S. Pregnancy outcome after hysteroscopic myomectomy. Gynecol Endocrinol. 2014;30(2):149–52.

    Article  PubMed  Google Scholar 

  83. Roy KK, Singla S, Baruah J, Sharma JB, Kumar S, Singh N. Reproductive outcome following hysteroscopic myomectomy in patients with infertility and recurrent abortions. Arch Gynecol Obstet. 2010;282(5):553–60.

    Article  PubMed  Google Scholar 

  84. Hassiakos D, Christopoulos P, Vitoratos N, Xarchoulakou E, Vaggos G, Papadias K. Myomectomy during cesarean section: a safe procedure? Ann N Y Acad Sci. 2006;1092:408–13.

    Article  CAS  PubMed  Google Scholar 

  85. Kaymak O, Ustunyurt E, Okyay RE, Kalyoncu S, Mollamahmutoglu L. Myomectomy during cesarean section. Int J Gynaecol Obstet. 2005;89(2):90–3.

    Article  CAS  PubMed  Google Scholar 

  86. Kim YS, Choi SD, Bae DH. Risk factors for complications in patients undergoing myomectomy at the time of cesarean section. J Obstet Gynaecol Res. 2010;36(3):550–4.

    Article  PubMed  Google Scholar 

  87. Li H, Du J, Jin L, Shi Z, Liu M. Myomectomy during cesarean section. Acta Obstet Gynecol Scand. 2009;88(2):183–6.

    Article  PubMed  Google Scholar 

  88. Park BJ, Kim YW. Safety of cesarean myomectomy. J Obstet Gynaecol Res. 2009;35(5):906–11.

    Article  PubMed  Google Scholar 

  89. Simsek Y, Celen S, Danisman N, Mollamahmutoglu L. Removal of uterine fibroids during cesarean section: a difficult therapeutic decision. Clin Exp Obstet Gynecol. 2012;39(1):76–8.

    CAS  PubMed  Google Scholar 

  90. Song D, Zhang W, Chames MC, Guo J. Myomectomy during cesarean delivery. Int J Gynaecol Obstet. 2013;121(3):208–13.

    Article  PubMed  Google Scholar 

  91. Cesen-Cummings K, Houston KD, Copland JA, et al. Uterine leiomyomas express myometrial contractile-associated proteins involved in pregnancy-related hormone signalling. J Soc Gynecol Investig. 2003;10:11–20.

    Article  CAS  PubMed  Google Scholar 

  92. Burbank F. Childbirth and myoma treatment by uterine artery occlusion: do they share a common biology? J Am Assoc Gynecol Laparosc. 2004;11:138–52.

    Article  PubMed  Google Scholar 

  93. Walker CL, Cesen-Cummings K, Houle C, et al. Protective effect of pregnancy for development of uterine leiomyoma. Carcinogenesis. 2001;22:2049–52.

    Article  CAS  PubMed  Google Scholar 

  94. Yang JH, Chen MJ, Chen CD, Chen SU, Ho HN, Yang YS. Optimal waiting period for subsequent fertility treatment after various hysteroscopic surgeries. Fertil Steril. 2013;99(7):2092–6.

    Article  PubMed  Google Scholar 

  95. Chang WC, Chang DY, Huang SC, et al. Use of three-dimensional ultrasonography in the evaluation of uterine perfusion and healing after laparoscopic myomectomy. Fertil Steril. 2009;92:1110–5.

    Article  PubMed  Google Scholar 

  96. Darwish AM, Nasr AM, El-Nashar DA, et al. Evaluation of postmyomectomy uterine scar. J Clin Ultrasound. 2005;33:181–6.

    Article  PubMed  Google Scholar 

  97. Seinera P, Gaglioti P, Volpi E, et al. Ultrasound evaluation of uterine wound healing following laparoscopic myomectomy: preliminary results. Hum Reprod. 1999;14:2460–3.

    Article  CAS  PubMed  Google Scholar 

  98. Kumakiri J, Kikuchi I, Kitade M, et al. Evaluation of factors contributing to uterine scar formation after laparoscopic myomectomy. Acta Obstet Gynecol Scand. 2010;89:1078–83.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Cleveland Clinic, 9500 Euclid Avenue, A81, Cleveland, OH, 44195, USA

    Linnea R. Goodman MD, Lindsey N. Valentine MD & Tommaso Falcone MD

Authors
  1. Linnea R. Goodman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lindsey N. Valentine MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tommaso Falcone MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Linnea R. Goodman MD .

Editor information

Editors and Affiliations

  1. Gynecology and Obstetric, Vito Fazzi Hospital, Lecce, Lecce, Italy

    Andrea Tinelli

  2. Obstetric and Gynecology, Santa Maria Hospital, Bari, Italy

    Antonio Malvasi

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Goodman, L.R., Valentine, L.N., Falcone, T. (2015). Myoma in Pregnancy. In: Tinelli, A., Malvasi, A. (eds) Uterine Myoma, Myomectomy and Minimally Invasive Treatments. Springer, Cham. https://doi.org/10.1007/978-3-319-10305-1_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-10305-1_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-10304-4

  • Online ISBN: 978-3-319-10305-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation