Size Counts
A 2004 study performed at the University of North Carolina in Chapel Hill revealed that small uterine fibroids are associated with a heightened risk for miscarriage. Uterine fibroids grow inside or just outside of a woman's uterus, and though they are benign and non-cancerous, may cause adverse effects and severe symptoms. Researchers posit that over one in every five women of childbearing age will develop fibroids, even though many of them will have no noticeable symptoms. Experts are still looking into how these growths affect pregnancy outcomes in terms of the rates for miscarriage, intrauterine growth restriction (IUGR), and premature labor and delivery.
Poor Outcomes
Dr. Katherine Hartmann is the lead author of this study. Hartmann is assistant professor of obstetrics and gynecology and also epidemiology at the UNC's schools of public health and medicine. "No studies have prospectively investigated these risks in a large cohort of women early in pregnancy where presence of fibroids was uniformly assessed using ultrasound imaging. This is the first large-scale prospective study to do that," says Hartmann. She adds that since fibroids are so common, poor obstetric outcomes are having a tragic effect on a huge number of couples. Hartmann bemoans the fact that too few studies have been performed that might help physicians understand more about fibroids and their effects on pregnancy.
Dr. Hartman believes that even those ultrasound studies that have been performed are flawed since doctors only chose participants for inclusion based on their having fibroids that measured a minimum of 3 centimeters. Anything smaller was not termed a fibroid by these researchers. Because of this, the study results were distorted, based as they were on an arbitrary classification of what is and isn't a fibroid.
Never Diagnosed?
Hartmann's pilot study included 1,600 participants. The researchers found that 170 of the participants had fibroids. The research team discovered that most of those found to have fibroids had never been diagnosed as such by their doctors. Or perhaps it makes more sense to state that no one bothered to tell them they had the condition.
This pilot study reveals that women with fibroids have a 55% chance of miscarriage. Researchers believe that the most significant finding in this study is that smaller fibroids pose more of a miscarriage risk than do larger fibroids. Another finding from the study is that fibroids can bring about miscarriage at any time during the first trimester.
The National Institute for Child Health and Human Development has offered the team a grant of $3 million to take this research to the next level. Hartmann and team plan to enroll a further 3,300 women of varied ethnicities from 15 North Carolina counties who are either just beginning to plan a pregnancy or are already in very early pregnancy.
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