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Uterine Fibroids pp 311–333Cite as

Uterine Fibroids and Recurrent Pregnancy Loss

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Abstract

Fibroids are observed in up to 10.7% of pregnant women and may impact pregnancy outcome. The cumulative risk of sporadic miscarriage when intramural fibroids are noted in the first trimester via ultrasound was estimated to be 20.4%. However, the prevalence of uterine fibroids in women with recurrent pregnancy loss (RPL) is estimated to be only 4.08%. The workup for patients meeting the RPL diagnostic criteria should include genetic karyotype of both parents, endocrine evaluation, uterine assessment with evaluation of the endometrial cavity, and antiphospholipid antibody screening where appropriate. It is generally agreeable that submucous fibroids and intramural fibroids distorting the endometrial cavity should be removed particularly in the context of reproductive complications. On the other side, noncavity-distorting large endometrial fibroid may be associated with sporadic or recurrent pregnancy loss as illustrated in the two cases presented in this chapter. Properly designed studies to evaluate the impact of surgical removal of this subcategory on reproductive outcome are warranted.

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Abbreviations

APH:

Antepartum haemorrhage

APS:

Antiphospholipid syndrome

FDA:

Food and Drug Administration

FSH:

Follicular stimulating hormone

GA:

Gestational age

GDM:

Gestational diabetes mellitus

HSG:

Hysterosalpingogram

MRgFUS:

Magnetic resonance-guided focused ultrasound surgery

MRI:

Magnetic resonance imagine

PPH:

Postpartum hemorrhage

PROM:

Premature rupture of membranes

RCT:

Randomized control trial

RFVTA:

Radiofrequency volumetric thermal ablation

RPL:

Recurrent pregnancy loss

SIS:

Saline infusion sonography

UAE:

Uterine artery embolization

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Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, The University of British Columbia, D415A-4500 Oak Street, Vancouver, BC, V6H 3N1, Canada

    Mohamed A. Bedaiwy MD, PhD, Christa Lepik MD & Sukinah Alfaraj MD

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  1. Mohamed A. Bedaiwy MD, PhD
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  2. Christa Lepik MD
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  3. Sukinah Alfaraj MD
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Corresponding author

Correspondence to Mohamed A. Bedaiwy MD, PhD .

Editor information

Editors and Affiliations

  1. Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of Florida, Gainesville, Florida, USA

    Nash S. Moawad

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Bedaiwy, M.A., Lepik, C., Alfaraj, S. (2018). Uterine Fibroids and Recurrent Pregnancy Loss. In: Moawad, N. (eds) Uterine Fibroids. Springer, Cham. https://doi.org/10.1007/978-3-319-58780-6_17

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  • DOI: https://doi.org/10.1007/978-3-319-58780-6_17

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