International Journal of Research and Innovation in Applied Science (IJRIAS) | Volume VI, Issue III, March 2021|ISSN 2454-6194 www.rsisinternational.org Page 31 Prevalence of Uterine Leiomyoma Coexisting with Intrauterine Pregnancy Shire Ebere Mercy 1 , Lekpa K. David 2 1 Rivers State College Of Health Science and Management Technology, Port Harcourt, Nigeria 2 Department of Anatomy, Faculty of Basic Medical Science, College of Health Sciences, University of Port Harcourt, Nigeria Abstract: Uterine myoma also known as fibroid is a mass of compacted smooth muscle and fibrous tissue that grows on the wall (or sometimes on the outside) of the uterus. Estrogen and progesterone are recognized as promoters of tumor growth. During pregnancy, the influx of these hormones are said to have effects on the co-existing myomas. The objective of this study was to establish the prevalence of uterine leiomyoma coexisting with intrauterine pregnancy and investigate the relationship between patient age, gestational age (GA), myoma size and location of myomas in pregnant women living in Port Harcourt Metropolis, Rivers state Nigeria. It is a retrospective study from June 2010 to December, 2018. Data was obtained from case files of 150 gravid female patients (with myoma = 80, without Myoma = 70) who reported for ultrasound scans, these files were evaluated and analyzed using their Gestational age to compare the size of myoma. From the results there was a remarkable increase in myoma existing with pregnancy with rise in maternal age. A total of 35 patients between the ages of 40-45years were scanned and were found to have the highest number of myomas coexisting with their pregnancies (with myoma, n=30(85.71%). This was closely followed by patients between the ages of 35-39 years were 50 subjects where scanned and 50% had myomas coexisting with their pregnancies (with myoma, n=25(50%)). Patients between the ages of 20-24years had the least number of myoma coexisting with their pregnancies (with myoma, n= 3(33.33%)). The various age distribution of subjects and fibroid incidence was analyzed using chi-square (X 2 = 28.471, df = 5, p value=0.00002). Patients between ages 40-45years has the highest number of pregnancies coexisting with uterine fibroids in Port Harcourt Metropolis, Rivers State, Nigeria. Ultrasonography is an important modality used in detecting the presence, size and location of myomas especially in early pregnancy. The growth pattern of myoma in pregnancy in our locality was significant. Myomas grow in pregnancy at 3-6 weeks interval (4.5 weeks mean interval) at the growth rate of 0.667mm per week especially from first trimester to second trimester. The incidence of myoma in this study was 53.5% and was found to be significant in women of age 40-45 years. The most common fibroids are subserous (20%), Submucous (20%) and intramural fibroids(20%). Follow-up scans should always be requested in cases of leiomyoma co- existing with pregnancy to determine any change in size of myoma as the pregnancy progresses. I. INTRODUCTION ibroids are important features in pregnancy now than in the past because many women are delaying child bearing to their thirties, the time of greatest risk for fibroid growth (Vollenhoven et al., 2000). Several studies showed that the actual etiology of myomas is unknown but there are growth factors which are also risk factors of fibroid tumorigenesis. The factors with increased risk are: early menarche and age (late reproductive years) (Marshall et al., 2000), parity (Marshallet al., 2006), obesity) Marshall et al., 2006), African-American ethnicity (Baird et al., 2002) and tamoxifen (Deligdisch, 2000). Pregnancies may be faced with adverse outcomes without clear risk factors. Therefore assumptions have been made that routine ultrasound in all pregnancies will prove beneficial by enabling early detection of some risk factors and improve management of pregnancy complications (Vollenhoven et al., 2000). According to Buttram (1986) a common clinical perception prevails that myomas increase in size during pregnancy. With the advent of ultrasonographic studies, however, several reports have noted that only a minority of myoma (one-third or less) increase in size during pregnancy, whereas the majority remain stable or decrease in size (Aharoni et al., 2003; Rosati et al., 2002; Strobelt et al., 2004). In a prospective study by Aharoni et al., (2003), 32 leiomyomas (fibroids) in 29 pregnant women were examined with ultrasound every 3-8 weeks. Each patient had between 3 and 6 scans (mean 4.4) during the course of pregnancy and 13 patients had a final scan at 6 weeks postpartum. An individual growth curve was established for each tumour and the patterns of growth were analyzed. No increase in size during the pregnancy was observed in 25 fibroids (78%). Only 7 (22%) increased in size but by no more than 25% of the initial volume. At 6 weeks postpartum the size of the fibroids did not differ significantly from the size during pregnancy. The larger the myoma, the greater the likelihood of growth (Strobelt et al., 2004). Myoma size can increase as a result of hypertrophy and edema, while shrinkage of the tumor may occur as a result of degenerative changes secondary to ischaemia. Rosati et al., (2002) examined sonographically 36 pregnant women with a single uterine myoma at 2 to 4 weeks intervals. The initial diagnosis was made in 12 patients before pregnancy and in the other 24 patients between 9 and 12 weeks of gestation. Thirty- four women had a scan 4 weeks after delivery. A reduction in size was observed in puerperium, which may indicate a return to its initial volume. Estrogen and progesterone are recognized as promoters of tumor growth. During pregnancy, the influx of this hormones are said to have effects on the co-existing myomas (Goodman et al., 2006). Uterine myomas usually develop before pregnancy and because many women experience no symptoms, they may not realize they have them until they F