Fibroid Removal May Prevent Recurrent Miscarriages

According to a study published in the journal Human Reproduction, fibroids, or benign tumors made out of fibrous tissue and muscles within or surrounding the womb, may just help in considerably lowering a woman’s risk for miscarriages.

The research was conducted for 20 years by Professor Tin-Chin Li and his colleagues from the Sheffield Teaching Hospitals and the University of Sheffield.

966 women in the study were scanned for uterine abnormalities such as fibroids, using different methods such as transvaginal ultrasound and radiology. The researchers found out that 79 percent of the subjects had fibroids.

Fibroids may be classified into three kinds:
•    Submucosal – fibroids growing in the muscle under the inner lining of the womb’s wall and growing into the middle portion of the womb, distorting the cavity
•    Intramural – fibroids growing in the muscle wall of the womb. It’s also the most common type of fibroid and these do not distort the cavity. Its protrusion into the outer membrane of the womb is less than 50%.
•    Subserosal – fibroids growing outside the womb’s wall into the woman’s pelvis; these do not distort the cavity and protrudes into the outer membrane of the womb at higher than 50%

Said one of the researchers, Dr. Sotirios Saravelos, “Among women with recurrent miscarriages, the fibroids prevalence was 8.2%.” He adds, “This is the first time that it has been shown that removing fibroids that distort the uterine cavity may increase the chances of a subsequent live birth in women with recurrent miscarriages."

 

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Professor Li performed the procedure called hysteroscopy in order to remove cavity-distorting fibroids from 25 of the women and for the removal of non cavity-distorting fibroids from 54 women. These were compared to the other 285 women in the control group with unexplained miscarriages.

Those women who underwent surgical intervention for their miscarriages had lower miscarriage rates, from 21.1% to 0%. Live births among the same group increased from 23.3 to 52%.

What’s important to note as well was that women who received psychological supportive care also experienced lower miscarriage rates, from 17.6% to 0%. Live births among the same group increased from 20.6 to 70.4%.

Said Saravelos, “These results are interesting because they suggest that the finding of fibroids in women with recurrent miscarriage does not necessarily imply that the fibroids are the only cause of the miscarriage. In addition, they suggest that surgical intervention is not the only means whereby patients with recurrent miscarriage benefit from attending a specialized, dedicated clinic.”

“It has been recognized since the 1980s that women with unexplained recurrent miscarriage have very good pregnancy outcomes following referral to a dedicated clinic without the need for any intervention, and with psychological supportive care, i.e. tender loving care, alone. This usually takes the form of regular visits to a dedicated recurrent miscarriage clinic, regular antenatal scans to check the condition of the baby, reassurance to the mother from the specialist that everything is progressing well and specialist antenatal counseling throughout the pregnancy.”

The researchers share that their study indeed has limitations and perhaps randomized controlled testing would help confirm the validity of the results. Future studies would need to be conducted with the help of different miscarriage clinics.


Sources:
•    September 29, 2011. Kate Johnson. “Removal of Submucosal Fibroids Reduces Recurrent Miscarriage” medscape.com
•    “Recurrent Miscarriages May be Prevented by Removing Fibroids” drugmega.com
•    September 28, 2011. “Removal of Fibroids That Distort the Womb Cavity May Prevent Recurrent Miscarriages, Study Suggests” sciencedaily.com
•    October 3, 2011. “Study: Women with Recurrent Miscarriages May Benefit From Fibroid Removal” growingyourbaby.com

Photo by otisarchives1 via flickr creative commons