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Sep 13, 2013
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The Risks of Uterine Fibroids and Pregnancy

“It is not advisable to get pregnant now!”

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A woman may come across such a shocking situation when the ultrasound scans show abnormal growths in and around her uterus. The gynaecologist diagnoses these as fibroids and the plans of getting pregnant are put on hold. Fibroids are intrauterine tumors but most of the time are non malignant. Sometimes the fibroids are so small that they don’t show any significant symptoms like pain or bleeding.

Myomas for an aspiring mother can be risky if they are large and many. Some fibroid pains are intolerable hence immediate medical attention is warranted. However, if the woman is already pregnant, what can be the possible problems she can face as she approaches her ninth month?

Medical research show most uterine fibroids do not change during pregnancy. Only one third of fibroids enlarge during the first trimester. Vast majority of women with fibroids have an smooth pregnancy and delivery. Unfortunately some women have some problems during their pregnancy. Uterine fibroids are linked to a greater rate of miscarriages, placental abruptions, premature labor, abnormal positioning of the baby, difficult childbirth. There are several ways that a pregnancy can be affected by uterine tumors.

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The Potential Problems:

  • If you are planning to have a baby, large fibroids in uterus can prevent conception. It becomes difficult to conceive if they are present in the location where it blocks conception.
  • In Pregnancy, Fibroids tend to grow quickly with the rise in estrogen levels. However many specialist don’t agree with this concept. They have observed very few grow and after the delivery it retains the original shape.
  • Fibroids can also cause sudden miscarriages. Expectant woman should opt for sedentary work chores to avoid physical and mental stress. If a woman is experiencing recurrent miscarriages, then investigation is mandatory.
  • Not all fibroids threaten pregnancy. However, if a miscarriage doesn’t occur, an pregnant woman can still experience premature labor. The premature labor can be due to a sudden membrane rupture inside the uterus. Rupturing inside the uterus can lead to premature labor.
  • Intrauterine tumors can also cause trouble even after the delivery of the baby. If the mother has large multiple fibroids inside the uterus, the placenta retained inside can cause harm.
  • If the woman is diagnosed, but shows no dangerous symptoms and she desires to have a child, good news is – she can go ahead with her plans. This should happen with the pre-conception counseling from her doctor as this can improve the chances to have a healthy child.

It is a good idea to have the fibroids removed before getting pregnant. One should not gamble with the pregnancy if she has large tumors.

Effects on Pregnancy:

Studies observed that between 10% to 30% women with fibroids, face complications during their pregnancy. However this outcome is challenged by many because of inconsistent correlations between fibroids and pregnancy.
How fibroids cause complications in pregnancy?, it is still not researched well. It is just assumed that physical obstruction or abnormal distention of the uterus cause problems in pregnancy by fibroids. The effects can be different in different trimesters.

  • First Trimester -

Miscarriage 

Studies show rate of miscarriage in women with fibroids was 14% compared with 7% in women without them. It is also found that the size of a fibroid does not affect the risk of miscarriage, but that the number of fibroids maybe a risk. Miscarriage due to multiple fibroids is 23% compared to 8% with single fibroid. Type of the fibroid in the uterus also plays a significant role in miscarriage. Miscarriages are less in intramural or submucosal fibroids.

Bleeding

The location of the fibroid influences the bleeding. If the fibroid is nearer to the placenta, the risk of bleeding is increases significantly to 60% from 9% if tumor is situated away from the placenta.

  • Second and Third Trimester -

Premature Rupture -
Uterine fibroids can induce premature labor and childbirth. The risk of preterm labor with fibroids is 8%. Fibroids can not be fully blames for preterm premature rupture of the membranes (PPROM) of the amniotic sac around the baby. Strangely research reveals fibroids actually decrease PPROM.

Placental Abruption -

Placental abruption are caused by submucosal fibroids, retroplacental fibroids and fibroids with a volume greater than 200 cubic centimeters. Fibroids tend to reduce blood flow near the placental tissues.

Foetal Abnormalities and Growth Retardation -

Research shows that the growth of the fetus is not affected by myomas but a large fibroid or fibroids can press and distort the uterus cavity. This may of the uterus lead to a foetal abnormality. The congenital abnormalities like an abnormal twisting of the neck, lateral compression of the baby’s skull and limb reduction defects are however linked to submucosal fibroids.

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Labour and Delivery -

Uterine fibroid increases the chances of caesarean section. This can be partly due to labour dystocia. Other factors for caesarean section are: Large and multiple fibroids, foetal abnormal postioning submucosal fibroids and lower uterine tumors.

Postpartum Bleeding -

A fibroid may distend the the womb causing contractions of the uterine muscles called myometrium. This leads to loss of muscle strength and postpartum hemorrhage. In many cases women opt for hysterectomy after childbirth.

Retained placenta -

The case of retained placenta of the uterus is more in women with fibroid. This happens if the tumor is located in the lower segment.

myomectomy

Myomectomy -

Though this is rare, but studies have found that there have been cases of uterine ruptures in women who have undergone myomectomy. Although Myomectomy and UAE are the two important treatments rendered to the pregnant women.

Fibroids are benign and very common in women between the age of 30 and 40. Uterine fibroids are linked pregnancy complications. The main complication is pain. The symptoms can generally be managed with natural treatment. Caesarean section is generally advised to those who have undergone myomectomy.

One  shouldn’t get disheartened with the potential risk in pregnancy. There are several proven systems of treating them.  It is good to know about the risks before one adopts a treatment which offers  a smooth uncomplicated delivery where no life is risked.

2 Comments

  • It is advisable and better to consult an expert doctor before going to plan pregnancy if suffers from the problem of uterine fibroid to avoid any of the further medical problems

    • It is always advisable to consult your expert doctor.

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