Impact of intramural non-cavity-distorting leiomyoma on placental histopathology and perinatal outcome in singleton live births resulting from in vitro fertilization treatment.

Volodarsky-Perel, Alexander; Nu, Tuyet Nhung Ton; Tulandi, Togas; Buckett, William; Gil, Yaron; Machado-Gedeon, Alexandre; Cui, Yiming; Shaul, Jonathan; Dahan, Michael H.

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 non-cavity-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.

HISTOPATHOLOGY; UTERINE fibroids; HUMAN in vitro fertilization; FIBRIN; FERTILIZATION in vitro; SMOOTH muscle tumors; THERAPEUTICS

Journal of Assisted Reproduction & Genetics, 2020, Vol 37, Issue 8, p1963

1058-0468

Academic Journal

10.1007/s10815-020-01867-7