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Archives of Gynecology and Obstetrics

, Volume 299, Issue 1, pp 13–33 | Cite as

Use of pre-operative imaging for symptomatic uterine myomas during pregnancy: a case report and a systematic literature review

  • Gaetano ValentiEmail author
  • Pietro Milone
  • Serena D’Amico
  • Lisa Maria Grazia Caldaci
  • Amerigo Vitagliano
  • Fabrizio Sapia
  • Michele Fichera
Review
  • 61 Downloads

Abstract

Purpose

Uterine fibroids (UFs) occur in 10% of pregnancies and may lead to severe maternal–fetal complications, mainly depending on UFs characteristics and the distance to the uterine cavity (UC). When symptomatic, UFs are managed medically. Nevertheless, in about 2% of cases, surgery becomes necessary. Entry into the UC should be avoided during myomectomy. Consequentially, pre-operative assessment of this risk could be beneficial. Ultrasonography (US) represents the gold standard for UFs assessment; however, scarce evidence has been produced to assess the role of magnetic resonance imaging (MRI). The aim of the present study was to summarize current evidence about the pre-operative use of imaging techniques for UFs during pregnancy.

Methods

A systematic research of the literature was conducted in Scopus, PubMed/MEDLINE, ScienceDirect and the Cochrane Library, including case reports and case series. A case report was also discussed. We collected data regarding patients, imaging assessment, UFs characteristics, surgical information, timing and modality of delivery.

Results

According to our search strategy, 66 articles were selected and 210 patients were included. US assessment was reported in 36 (17%) cases. MRI was reported in 10 (4.7%) cases. Only in one case, MRI was used to measure the distance between UFs and UC.

Conclusion

US allows an adequate pre-operative evaluation of anterior, submucosal or pedunculated symptomatic UFs in pregnancy. However, compared to US, MRI may provide a more accurate evaluation of multiple, large, intramural or posterior UFs and could measure the distance between UFs and UC more accurately.

Keywords

Laparoscopy myomectomy Laparotomy myomectomy Leiomyoma Magnetic resonance imaging Pregnancy 

Notes

Author contributions

GV: Conceptualization; Writing—original draft; Writing— review and editing; project administration; supervision. PM: Writing—review and editing; data curation; supervision; visualization. SD: data curation; investigation; formal analysis. LMGC: data curation; investigation; formal analysis; supervision. AV: Writing—review and editing; supervision; formal analysis; methodology. FS: Data curation; formal analysis; methodology; investigation. MF: Project administration; Conceptualization; investigation; supervision; validation.

Funding

No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent for research and publication purposes was obtained from the patient mentioned in the study before collecting data.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General Surgery and Medical Surgical SpecialtiesUniversity of CataniaCataniaItaly
  2. 2.Department of Medical and Surgical Sciences and Advanced TechnologiesUniversity of CataniaCataniaItaly
  3. 3.Unit of Gynecology and Obstetrics, Department of Women and Children’s HealthUniversity of PaduaPaduaItaly

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