Is It Possible to Discover Pregnancy During Uterine Fibroid Surgery?

Is it possible to discover a pregnancy during a uterine fibroid removal surgery?

Hello, I had sexual intercourse in mid-March without taking safety precautions, and I took emergency contraception the next day.
There was no further sexual activity during this period.
However, in mid-May, I discovered I was pregnant during a surgery to remove uterine fibroids.
Is this possible? Thank you for your assistance.

Niming, 30~39 year old female. Ask Date: 2017/07/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology

It is possible, as the effectiveness of emergency contraception is only about 80%.

Reply Date: 2017/07/02

More Info

Yes, it is indeed possible to discover a pregnancy during uterine fibroid surgery, even if the pregnancy was not initially suspected. This situation can occur for several reasons, particularly in cases where the pregnancy is early or if there are irregularities in menstrual cycles that may lead to misinterpretation of symptoms.

When a woman has a regular menstrual cycle, she typically expects her period to arrive at a certain time. However, if there are irregularities, such as those caused by uterine fibroids, it can be challenging to determine whether a missed period is due to pregnancy or other factors. In your case, since you took emergency contraception the day after unprotected intercourse, it is understandable that you might have assumed pregnancy was unlikely. Emergency contraception is designed to prevent ovulation and fertilization, but it is not 100% effective, especially if ovulation has already occurred.

During surgery for fibroids, the surgeon may perform an ultrasound or visual inspection of the uterus. If a pregnancy is present, it may be detected at this time, even if the woman was unaware of it. Early pregnancies can sometimes be difficult to detect through standard urine tests or blood tests, especially if the levels of human chorionic gonadotropin (hCG) are low. In some cases, women may experience what is known as a "cryptic pregnancy," where they do not exhibit typical signs of pregnancy and may receive negative test results until much later in the pregnancy.

The presence of fibroids can also complicate the detection of pregnancy. Fibroids can cause changes in the shape of the uterus and may obscure the view of a developing embryo during imaging studies. This can lead to a situation where a pregnancy goes unnoticed until surgical intervention is performed.

If a pregnancy is discovered during fibroid surgery, the surgical team will need to assess the situation carefully. Depending on the gestational age of the pregnancy and the specifics of the fibroid surgery, the surgical approach may change. If the pregnancy is very early, the surgeon may proceed with the fibroid removal while taking care to preserve the pregnancy. However, if the pregnancy is more advanced, the risks to both the mother and the fetus will need to be evaluated, and the surgical team may need to take additional precautions.

In summary, while it may seem surprising to discover a pregnancy during fibroid surgery, it is entirely possible, especially in cases where the pregnancy is early or when there are irregularities in the menstrual cycle. If you find yourself in this situation, it is crucial to discuss your options and any potential risks with your healthcare provider, who can provide guidance based on your specific circumstances.

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