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

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 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.

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Acknowledgments

The authors express their appreciation to the embryologists, nurses, and other team members of McGill University Reproductive Centre. We especially appreciate the contribution of Nancy Lamothe for managing the database.

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Authors

Contributions

All authors contributed to the study conception and design. Material preparation was performed by Tuyet Nhung Ton Nu, William Buckett, Yaron Gil, Alexander Volodarsky-Perel, and Michael H. Dahan. Data collection was performed by Alexandre Machado-Gedeon, Yiming Cui, Jonathan Shaul, and Alexander Volodarsky-Perel. Data analysis was performed by Togas Tulandi, Alexander Volodarsky-Perel, and Michael H. Dahan. The first draft of the manuscript was written by Alexander Volodarsky-Perel, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alexander Volodarsky-Perel.

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The authors declare that they have no conflict of interest.

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McGill University Health Centre Research Ethics Board approved the study (MUHC 2019-5026).

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Volodarsky-Perel, A., Nu, T.N.T., Tulandi, T. et al. Impact of intramural non-cavity-distorting leiomyoma on placental histopathology and perinatal outcome in singleton live births resulting from in vitro fertilization treatment. J Assist Reprod Genet (2020). https://doi.org/10.1007/s10815-020-01867-7

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Keywords

  • Intramural myoma
  • Uterine cavity
  • Placenta
  • Histopathology
  • Dysfunctional labor