If you are planning your pregnancy or already expecting, then there are many health related matters that you might be worried about. One such worry is the fear of developing uterine fibroids and wondering whether they are cancerous.
While some studies suggest uterine fibroids to pose threat for pregnancy in the first trimester, others suggest that chances of cesarean section increases with this.
The fibroid size and its location in the uterus are some of the factors that determine if fibroid can result in obstetric complications. Read ahead to understand more about fibroids during pregnancy and their symptoms to avoid any delay in treating them.
What Are Uterine Fibroids?
Uterine fibroids, also referred to as leiomyoma or myoma of uterus, are non-cancerous tumors that grow abnormally in the uterine region. The good news is that in no way does fibroid tumor increase your chances of uterine cancer and it is not cancerous in any way. This is also known as myoma or leiomyoma. Let’s have a closer look here:
- It is a mass of fibrous tissue and compacted muscle that grows along the uterus wall.
- The tumor can be of the size of a pea or it may be as large as a grape fruit.
- Fibroid tumor is common among 50% to 80% of women.
- They usually develop after the commencement of menstrual cycle.
[ Read: Retained Placenta ]
Who Gets Fibroids?
Although there are no concrete factors proved to trigger a fibroid growth, below are some factors that make women susceptible to them. Fibroids are more common among:
- Women around 35 years of age.
- Women who are overweight or obese.
- Women who are not on contraceptive pills or injection.
During pregnancy too, there is a possibility to develop fibroids. If you are planning to conceive or are already pregnant.
[ Read: Yeast Infection During Pregnancy ]
Types Of Fibroids During Pregnancy:
There are different kinds of fibroids based on the location where they sprout from in the uterine region:
1. Intramural Fibroids:
These fibroids are the most common types that grow within the muscle wall of the uterus.
- Intramural fibroids tend to grow large in size, making the uterus full.
- This further causes heavy bleeding during periods or even inability to conceive as they obstruct egg from being fertilized.
2. Submucosal Fibroids:
These fibroids grow under the inner lining of the uterus known as endometrial lining.
They cause heavy and painful periods along with fertility problems.
[ Read: Protein In Urine During Pregnancy ]
3. Subserosal Fibroids:
These fibroids grow on the outside of the uterus, stretching into the pelvis.
- Subserosal fibroids tend to put additional strain on the bladder, causing bowel related issues.
- Both submucosal and subserosal fibroids grow from a stalk like structure, sometimes sticking out of the uterus into the pelvic area.
[ Read: Pelvic Pain During Pregnancy ]
4. Cervical Fibroids:
As the name suggests, these fibroids grow in the neck of your cervix.
Uterine Fibroids During Pregnancy Symptoms:
It is very important that you stay aware of the signs and symptoms of uterine fibrosis in pregnancy, so that you do not confuse it to be something else. Have a look here:
- You may feel the urge to urinate frequently
- Feel pressure on your pelvis
- Pain in the back
- Pain in legs
- Abdominal pains
- Vaginal bleeding
- Painful periods
- Heavy blood loss that lasts for days together
- Pain while urinating
- Fullness of abdomen that causes extra pressure and constipation
- Trouble getting pregnant
- Frequent unexplained miscarriages
You must always report to your doctor about vaginal bleeding and abdominal pains to avoid any further complications.
Diagnosis For Uterine Fibroids:
Once your doctor is informed about the above symptoms, he or she will diagnose the presence of fibroids with the below tests:
- An ultrasound scan to examine the inside of your uterus
- The doctor will check for the presence of any lumpy structures or abnormality in the shape of your uterus.
- Once the initial doubt is confirmed, hysteroscopy is performed, where your doctor will check the inside of your uterus with more detail.
- During this procedure, a viewing tube is inserted into your vagina. Hysteroscopy usually detects the submucosal fibroids very easily.
Invasive Diagnostic Method:
Laparoscopy may be needed if your doctor decides that it needs to be done, to get the best picture of your problem.
- Subserosal fibroids are located easily with a laparoscopy.
- This is a procedure during which you will be given a general anaesthesia. Your doctor will make a tiny incision below the navel.
- A tube having a tiny camera is inserted via the incision to get a detailed look at the pelvic region.
[ Read: Hepatitis B During Pregnancy ]
Uterine Fibroids And Pregnancy Complications:
Fibroids generally develop before pregnancy. In many cases women remain unaware of the presence of the tumor until they get an ultrasound done.
- You can also detect the tumor with a pelvic exam. Also, watch out for the above mentioned symptoms.
- When you know about your fibroids beforehand, you can ask your doctor about the probable complications in your pregnancy.
- These are non-cancerous developments that generally do not interfere with your pregnancy.
- Around 30% of the women face complications in pregnancy such as abdominal pains along with vaginal bleeding.
- Unless your bleeding is substantial, your baby will be rarely affected.
- Submucosal fibroids directly affect the ability to conceive as they distort the entire uterus, thereby disturbing the implantation of the embryo even after fertilization.
- The sooner you try to conceive, the lesser are the chances of infertility due to fibroids or even the occurrence of the fibroids.
- If your doctor feels that the presence of a fibroid is affecting your plans to conceive, he or she may recommend you to try conceiving for up to two more years.
- If you are over 34, chances of conceiving become lower. This is the instance where your doctor will recommend treating the fibroid through any of the above options except UAE.
[ Read: Low Platelet Count During Pregnancy ]
Uterine Fibroids And The Effect On Your Baby:
Well, most probably your baby will not be affected in any way by the uterine fibroids. Let’s take a closer look here:
- Even though there are no such huge risk factors involved, the chances of premature delivery or miscarriage may be slightly high in this case.
- Your baby may be in an abnormal position at times during pregnancy.
- The fibroids can stall labor or may even block the passage if located near the opening of the cervix.
- These are rare problems that might increase the chances of a cesarean section.
[ Read: Fibroids During Pregnancy ]
Should Fibroids Be Treated?
The fibroids are not required to be removed unless they are seriously interfering with your routine, causing pain and discomfort.
- If you are already pregnant and the fibroids are fast growing inside, it is stated that pregnancy itself will minimize the growth.
- The more number of pregnancies you have, the lesser are the chances for the fibroids to develop.
Treatment During And After Pregnancy:
If you are already in the vicious trap of symptoms such as heavy menstrual bleeding, pain and difficulty in conceiving, you can insist your doctor to explain to you, the different treatments that are available for fibroids.
The final call will be taken by your health care provider looking at the seriousness of the condition. The main forms of fibroid during pregnancy treatment available are as below:
1. Hormone-Balancing Drugs:
Drugs that release a hormone called gonadotrophin may be prescribed. This hormone acts like a counteroffensive to your estrogen levels, reducing the production and thereby limiting the possibility of more fibroids growing.
- Gonadotrophin based drugs also help in shrinking the size of the existing fibroids.
- These drugs, also known as GnRHas are either prescribed in the form of injection, nasal spray or implants that are placed under your skin.
- GnRHas drugs have heavy side effects that result in hot flashes, dry vagina and weaker bones. Hence these are given over a long stretch of 3 to 6 months.
[ Read: Hot Flushes in Pregnancy ]
This is a surgical procedure that is used to remove the fibroids via operation. During this procedure, a surgery is performed with the help of laparoscopy or hysteroscopy.
- The recovery time from a myomectomy largely depends on the size of the fibroids removed.
- For larger fibroids, the period to recover is quite long where after you will be recommended a strict bed rest for many number of days.
- Myomectomy is highly useful for women who are seriously planning to conceive and have children. However, there is no guarantee that fibroids will not grow back again.
3. Endometrial Resection Or Ablation:
An endometrial resection or ablation is a non surgical process. This procedure is largely used for the treatment of submucosal fibroids that grow in the inner lining of the uterus.
- During this process, the endometrial tissue from the inner lining is surgically removed, in the area where the fibroid is growing.
- After the completion of treatment, women can try conceiving again.
Myolysis is a procedure that is carried out with a keyhole surgery using a laparoscope or hysteroscope.
- A sonogram or MRI is then used to detect the exact position of the fibroid.
- The surgeon will then insert a needle probe or electric current into the fibroid to cauterise both the fibroid and the surrounding blood vessels.
5. Uterine Artery Embolisation (UAE):
This process is performed by an experienced radiologist, who will use the magnetic resonance imaging (MRI) scan to detect the location of the fibroid.
- The MRI will also show a clearer view of all the blood vessels surrounding the fibroid.
- The radiologist will then inject a plastic plug into the blood vessel to cut off the blood supply to the growing fibroid.
- This is an effective procedure where fibroids are shrunk completely. This procedure also cannot guarantee that fibroids will never return again.
- Most women may have to repeat the procedure after few years once there is another onset.
- Unlike myomectomy or endometrial resection, UAE does not guarantee as whether women who undergo the process will conceive again.
In most of the cases, fibroids are nothing more than pain in the belly. Thus, there is no need to worry unless the symptoms are causing too much problem in your pregnancy.
Tips And Caution:
Your doctor will mostly put you on bed rest and medications for uterine fibroids while pregnant.
- Also, you will constantly check throughout your pregnancy, via ultrasound, to see how the fibroids present themselves from time to time.
- A necessary course of action will be taken by your doctor if he or she feels that there is an immediate threat to your pregnancy because of the fibroid.
- It is indeed an uncomfortable condition to have, but do not worry – there are many options available to treat fibroids. We hope this article has given you the info on such options and makes your decision a little easier.
Moms share with us if you had uterine fibroids in pregnancy and what symptoms you suffered from as a result of it.
Reference : 1
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