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01-01-2019 | Review

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

Authors: Gaetano Valenti, Pietro Milone, Serena D’Amico, Lisa Maria Grazia Caldaci, Amerigo Vitagliano, Fabrizio Sapia, Michele Fichera

Published in: Archives of Gynecology and Obstetrics | Issue 1/2019

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.

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Title: Use of pre-operative imaging for symptomatic uterine myomas during pregnancy: a case report and a systematic literature review
Authors: Gaetano Valenti
Pietro Milone
Serena D’Amico
Lisa Maria Grazia Caldaci
Amerigo Vitagliano
Fabrizio Sapia
Michele Fichera
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 1/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-018-4948-5

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

Abstract

Purpose

Methods

Results

Conclusion

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Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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Correction to: Long-term treatment of endometriosis with dienogest: retrospective analysis of efficacy and safety in clinical practice