Do myomectomies alter third‐trimester complications compared with women without myomectomies and uterine fibroids in situ: A retrospective cohort study of an American population database
Bibliographic record
Abstract
OBJECTIVE: To evaluate population characteristics and pregnancy, delivery, and neonatal complications in women with myomectomy prior to pregnancy versus intramural fibroids in situ. METHODS: Retrospective cohort study using hospital discharge data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 2004 to 2014 included. A population of 14 206 pregnancies post-myomectomy and 81 517 with fibroids in situ were analyzed, performing multivariate logistic regression with adjustment. RESULTS: Post-myomectomy patients were younger, with lower body mass index, higher in vitro fertilization use, more commonly Caucasians or Hispanics, and had higher rates of pregestational diabetes, smoking, illicit drug use, previous cesarean delivery, and multiple gestations, compared with the in-situ fibroid (ISF) group. Post-myomectomy patients had decreased rates of gestational hypertension (adjusted odds ratio [aOR] 0.87, 95% confidence interval [CI] 0.77-0.97), eclampsia (aOR 0.76, 95% CI 0.32-0.81), gestational diabetes (aOR 0.83, 95% CI 0.77-0.90), spontaneous vaginal deliveries (aOR 0.09, 95% CI 0.08-0.11), postpartum hemorrhage (aOR 0.77, 95% CI 0.68-0.88), and intrauterine fetal death (aOR 0.64, 95% CI 0.43-0.97). Conversely, they had increased risks of placenta previa (aOR 1.40, 95% CI 1.20-1.64), preterm delivery (aOR 1.16, 95% CI 1.07-1.24), cesarean section (aOR 8.64, 95% CI 7.71-9.69), uterine rupture (aOR 2.21, 95% CI 1.31-3.74), transfusions (aOR 1.79, 95% CI 1.59-2.02), and congenital anomalies (aOR 2.35, 95% CI 2.01-2.75). CONCLUSIONS: The ISF group experienced different complications than the post-myomectomy group. Pregnancies post-myomectomy could benefit from additional screening or interventions during pregnancy to reduce complications from malplacentation and ensure delivery in specialized centers to mitigate risks. Patients should be counseled regarding these potential risks. Increased understanding of the role of myomectomies on reproductive outcomes requires further prospective studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".