Impact of intramural non-cavity-distorting leiomyoma on placental histopathology and perinatal outcome in singleton live
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ASSISTED REPRODUCTION TECHNOLOGIES
Impact of intramural non-cavity-distorting leiomyoma on placental histopathology and perinatal outcome in singleton live births resulting from in vitro fertilization treatment Alexander Volodarsky-Perel 1,2 & Tuyet Nhung Ton Nu 3 & Togas Tulandi 1 & William Buckett 1 & Yaron Gil 1 & Alexandre Machado-Gedeon 1 & Yiming Cui 1 & Jonathan Shaul 1 & Michael H. Dahan 1 Received: 26 March 2020 / Accepted: 17 June 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluate the effect of non-cavity-distorting intramural leiomyomas on the placental histopathology pattern and perinatal outcome in singleton live births resulting from in vitro fertilization treatment. Methods The study population included all singleton live births following in vitro fertilization treatment with autologous oocytes during the period from 2009 to 2017. Primary outcomes included anatomical, inflammation, vascular malperfusion, and villous maturation placental features. Secondary outcomes included fetal, maternal, delivery, and perinatal complications. Results A total of 1119 live births were included in the final analysis and were allocated to the group of pregnancies with noncavity-distorting intramural myomas (n = 101) and without myomas (n = 1018). After the adjustment for confounding factors, the non-cavity-distorting intramural myomas were found to be significantly associated with assisted placental delivery (OR 2.4; 95% CI 1.5–3.9), furcate cord insertion (OR 3.6; 95% CI 1.4–9.3), circumvallate membranes insertion (OR 5.2; 95% CI 1.4–19.3), chronic deciduitis (OR 8.2; 95% CI 1.6–42.2), focal intramural fibrin deposition (OR 25.1; 95% CI 2.1–306.2), subchorionic thrombi (OR 3.6; 95% CI 1.7–7.6), maternal vasculopathy (OR 2.5; 95% CI 1.2–5.5), and chorangioma (OR 5.9; 95% CI 1.4– 25.2) as well as with the failure of labor progress (OR 2.4; 95% CI 1.3–4.4) and induction (OR 3.2; 95% CI 1.2–9.0). Conclusion Intramural non-cavity-distorting myomas have a significant impact on the placental histopathology with a higher incidence of dysfunctional labor. Keywords Intramural myoma . Uterine cavity . Placenta . Histopathology . Dysfunctional labor
Introduction Uterine leiomyomas (myomas) represent benign monoclonal tumors of smooth muscle cells and their prevalence reaches 60% among women of reproductive age [1]. The International Federation of Gynecology and Obstetrics (FIGO) classified
* Alexander Volodarsky-Perel [email protected] 1
Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, 1001 Decarie Blvd., Montreal H4A 3J1, Canada
2
Lady Davis Research Institute, Jewish General Hospital, McGill University, 3755 Chemin de la Côte-Sainte-Catherine, Montreal H3T 1E2, Canada
3
Department of Pathology, Royal Victoria Hospital, McGill University, 1001 Decarie Blvd., Montreal H4A 3J1, Canada
myomas according to their location in the uterine wall as submucous, intramural, and subserosal leiomyomas. Additional subclass
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