Uterine fibroids can be a problem during pregnancy. Myomas increase in size, interfering with the normal development of the fetus, and can also lead to miscarriage or premature birth. Therefore, if you are diagnosed with uterine fibroids, you will have to remain under the watchful eye of a gynecologist.

Pregnant uterine fibroidsmeans you are pregnant at high risk. Don't panic though, as your pregnancy doesn't have to be complicated. In practice, this means that a woman with fibroids visits the gynecologist more often. During the gynecological examination and ultrasound (they are done as many times as needed), the doctor checks whether the child is developing properly and checks how the fibroids behave, so that if necessary, they can quickly start action.

Contents:

    1. Pregnant uterine fibroids: benign nodules
    2. Uterine fibroids in pregnancy: symptoms
    3. Uterine fibroids when you are planning a pregnancy
    4. Uterine fibroids in pregnancy: risk to mom and baby
    5. Pregnant uterine fibroids under supervision
    6. Uterine fibroids and childbirth

Good to know: Uterine fibroids: types, symptoms and treatment

Pregnant uterine fibroids: benign nodules

Myomas are formed from the muscle tissue of the uterus, hence the name. They can appear singly or several or a dozen in a group. Most often they are about the size of a pea, but sometimes they are about the size of an orange. They develop in the uterine body, which becomes evenly enlarged. When there are many fibroids in the uterus, it loses its physiological shape.

Depending on the location,there are fibroids:

      • subserial - are outside the uterine body and grow towards the serosa that covers the abdominal wall of the uterus;
      • intramural - they develop in the uterine wall;
      • submucosa - they form inside the uterus and grow towards the mucosa that lines the uterine cavity.
      • pedunculated - connected to the uterine body by a strip of connective tissue (they look like a balloon on a string), they can develop outwards and towards the uterine cavity.

Uterine fibroids in pregnancy: symptoms

Small fibroids usually do not cause any discomfort. Often, even large bumps do not make themselves felt. Therefore, many women learn aboutmyomas by accident. Small nodules that do not cause any discomfort usually do not require treatment. However, you have to observe if and how fast they grow.

When the fibroids grow larger and cause minor discomfort, medication is given. If the tumors are large, growing rapidly, or showing persistent symptoms, surgery is required. The method of the procedure depends on the age and he alth of the woman and the size of the fibroids. But fibroids aren't treated in pregnancy.

Important

Uterine fibroids when you are planning a pregnancy

If the nodules are small, do not cause discomfort, their location does not threaten pregnancy, you can consider with your doctor whether to become pregnant, regardless of fibroids. Most often, however, you have to get rid of them first. If a woman wants to have children (regardless of whether she has given birth or not), a sparing operation is performed, i.e. the fibroids are removed, preserving the entire uterus.

After this procedure, it is recommended that you become pregnant as soon as possible to avoid recurrence of the disease. If the uterine cavity is opened, it is necessary to insert an intrauterine device, which acts as a contraceptive, speeds up the healing of the operated area and protects against adhesions. After three months, the IUD is removed and you can become pregnant. Then the delivery always takes place by caesarean section.

Uterine fibroids in pregnancy: risk to mom and baby

Uterine fibroids have a tendency to enlarge during pregnancy. But just because they are growing doesn't have to be a complication yet. They often grow in size with the baby and do not interfere with the normal development of the fetus or birth. However, you have to watch them because they can be dangerous for the mother and the baby. They can interfere with the proper development of a baby, cause premature uterine contractions and prevent natural childbirth.

The most trouble is submucosal fibroids. As they enlarge in the direction of the uterine cavity, they distort it and take the place intended for the baby. The toddler is too cramped, so he may develop more slowly and, as a result, be born smaller and weaker. Such located fibroids sometimes cause premature uterine contraction, which may result in miscarriage or early delivery.

Sub-serous fibroids, which spread towards the abdominal cavity and intramural, are less of a risk to the child. They do not take up space for the baby, so the fetus can develop properly. However, it happens that fibroids located under the serum or in the uterine wall change their location during pregnancy and bulge towards the center of the uterine cavity. Then they can disrupt the proper development of the fetus.

Sometimes a large subserial myoma orintramural located on the posterior wall of the uterus puts pressure on the rectum, causing pain. When wedged in the intestine, it makes it difficult to defecate. This leads to chronic constipation and, in extreme cases, to intestinal obstruction. Then the only solution is a liquid diet. You also need to drink as much as possible so that the food can travel smoothly through the entire digestive tract.

Pedunculated fibroids do not disturb the development of the fetus, but sometimes they are an obstacle to natural delivery.

Pregnant uterine fibroids under supervision

You must take into account the fact that during pregnancy you will be referred for a 3-day observation in the hospital, so that the doctors can accurately assess your and your baby's condition using ultrasound and CTG. Sometimes pregnant women are given steroid drugs intramuscularly, which accelerate the development of the toddler's lungs, so that in the event of early delivery, the risk of respiratory disorders is reduced.

If you are in danger of giving birth prematurely, consult your doctor in advance about where to give birth. It must be a hospital with a premature ward as your baby may need special care.

Uterine fibroids in pregnancy and childbirth

What about giving birth? In the case of small fibroids, natural delivery is possible. But if the fibroids are located low, near the inner opening of the uterus, they can block the baby's way into the world. The physician then usually decides to perform a caesarean section.

The indication for a cesarean can also be large fibroids - regardless of where they are located - and pedunculated. Do not defend yourself against a cesarean section, counting on the fact that maybe you will give birth somehow. It is better to decide on surgery right away than to expose the baby and yourself to complications that may arise during natural childbirth.

As a rule, fibroids are not removed by caesarean section. The exceptions are lumps that lie in the incision line and interfere with the closing of the uterus, and pedunculated fibroids that move freely in the abdominal cavity.

In other cases, their removal (laparoscopy or traditional surgery) can be performed at the earliest 6 weeks after delivery. This is not always necessary, as the fibroids shrink by themselves after the baby is born. But if you are planning another pregnancy, you will have to get rid of them.

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Pregnant examinations