Removal of serious submucosal fibroids in women attending a recurrent miscarriage clinic reduces the risk of second trimester miscarriage to zero, a UK study suggests.
Researchers followed 966 women attending a miscarriage clinic, and in those who had submucosal fibroids that distorted the uterine cavity removed, miscarriage rates during the second trimester fell from 22% to 0% and the live birth rate increased from 23% to 52%.
For other groups of women, simply being referred to the clinic dramatically increased their odds. Among 54 women with non-distorting fibroids – who did not have surgery – the second trimester miscarriage rate fell from 18% to 0% after referral and the live birth rate increased from 21% to 70%.
For these women, the rate of unexplained recurrent miscarriage also was reduced in the second trimester, falling from 8% pre-referral to 1.8% post-referral, and live birth rates increasing from 21% to 72%.
Study leader Dr Sotirios Saravelos, a clinical research fellow at the University of Sheffield, said removing submucosal fibroids could ‘eliminate miscarriage during the second trimester and double the live birth rate.’ But he said the success seen in other women showed specialist referral was still vital.