[Fibroma and pregnancy. Apropos of 51 case reports surveyed from April 1976 to December 1984].

The study is based on 51 observations of fibromas of diameter 3 cm or more associated with pregnancy. The authors report the characteristics of this pathology, which occurs at a frequency of one in two in women over 35 years of age, half of whom are primiparae. The frequency varies with the size of the fibroma and falls between 0.3 and 2%. The circumstances of detection vary but echography both improves detection and allows the development of the fibroma to be monitored. The only frequent complication is aseptic necrobiosis (25% of cases), but it is usually latent or moderate. Abortions, low insertions of the placenta and faulty presentations are more frequent, especially where large fibromas are involved, but nonetheless 3/4 of such pregnancies come to term without any serious problems. Fetal prognosis is, therefore, excellent and perinatal mortality is close to that of a control population. The proportion of cesarean sections is high (30 to 75%) and depends on the circumstances, the size of the fibroma and the occurrence of dystocias. Myomectomy should remain exceptional during pregnancy but will be frequently used towards the end of a cesarean section; indications for hysterectomy on the other hand remain very limited.