Fertility Following Myomectomy at Aba; Southeastern Nigeria

Background: While hysterectomy remains the gold standard treatment for fibroids; it is an unacceptable treatment option for women who wish to conserve their fertility. The actual effects of myomectomy on fertility remain uncertain though. Objective: The objective was to ascertain pregnancy and live birth rates among a small group of women undergoing abdominal myomectomy. Methods: The study population consisted of women of reproductive age intending to conceive soon after undergoing abdominal myomectomy. A total of 40 women who met the inclusion criteria were recruited for the study and followed-up for 4 years. Women who achieved pregnancy within the study period were analyzed in terms of their demographics and intra-operative findings. Results: The mean age of the women was 28 years (range 24-35) married for about 3 years. Majority of the women (50%) had more than 11 fibroid nodules; and the largest nodule was bigger than 5 cm in 35 women (87.5%). Cumulative pregnancy rate was 60% (24/40) while live birth rate was 22/40 (55%) following myomectomy and majority 19/22 achieved this within 2 years of myomectomy. Conclusion: Myomectomy for fibroid-associated infertility increase pregnancy rates such that approximately 60% of women undergoing the procedure subsequently conceive

Grandmultiparity and pregnancy outcome in Aba, Nigeria: a case-control study.

OBJECTIVE: To compare the incidence of antenatal and intrapartum complications and perinatal outcomes among women who had delivered five or more times (grandmultiparous) with those of age-matched controls who had delivered two to four times (multiparous). DESIGN: A case-control study. SETTING: A tertiary referral hospital in Aba, Nigeria. SAMPLE: Seven hundred and thirty-four grandmultiparous women were compared with 734 age-matched multiparous controls. METHODS: Maternal case records were retrieved from medical records department and analyzed with additional information obtained from the labor ward records. Statistical analysis was done using EPI info version 6; χ² test was used to analyze categorical variables. RESULTS: Grandmultiparity was associated with a significantly higher risk of antenatal anemia (P < 0.05), multiple pregnancy (P < 0.01), fetal macrosomia (P < 0.01), perinatal mortality (P < 0.01), and primary postpartum hemorrhage (P < 0.05). A significantly higher rate of cesarean deliveries was observed in the multiparous controls (P < 0.01), than the grandmultiparous women. CONCLUSION: Our study shows that there is an increased risk of antenatal anemia, multiple pregnancy, primary postpartum hemorrhage, and adverse perinatal outcomes in grandmultiparous women independent of maternal age.