Pregnancy and Uterine Fibroids: Concerns and Recommendations

Pregnancy and Uterine Fibroids

Dear Director Huang,
I discovered that I am pregnant two days ago, entering the seventh week.
Due to experiencing light bleeding for several days, I sought medical attention at two hospitals.
Both diagnosed that although the implantation site of the fertilized egg appears normal, there are approximately 4.5 cm fibroids on both sides, which may reduce the space available for fetal growth.
As for the cause of the bleeding, it is unclear whether it is a normal phenomenon in early pregnancy (as the miscarriage rate is already as high as 15%) or due to cervical polyps or the fibroids themselves.
I have been advised to continue monitoring the situation.

I am concerned that if the pregnancy progresses successfully, the limited uterine space may affect fetal growth.
If that is the case, should I consider terminating this pregnancy and treating the fibroids before trying to conceive again? Or should I follow the recommendations of the previous two doctors and observe the situation for a while longer?
I apologize for taking up your time, and I would greatly appreciate your valuable insights.
Thank you.

Erica, 30~39 year old female. Ask Date: 2020/01/29

Dr. Huang Yuande reply Obstetrics and Gynecology

Thank you for your question.
In general, having fibroids during pregnancy can increase the risk of preterm labor or unexplained abdominal pain.
However, a fibroid measuring 4.5 centimeters is unlikely to cause issues related to space constraints for fetal growth.
Therefore, it is recommended to maintain a calm mindset and continue with regular prenatal check-ups.

Reply Date: 2020/01/29

More Info

Pregnancy and uterine fibroids can indeed raise concerns for expectant mothers, particularly when complications such as bleeding occur. Uterine fibroids, also known as leiomyomas, are benign tumors that can develop in the uterus. They are quite common, with many women experiencing them during their reproductive years. The presence of fibroids during pregnancy can lead to various complications, but it is essential to understand the implications and the best course of action.

Firstly, it is important to note that the majority of women with fibroids have successful pregnancies. However, the size, location, and number of fibroids can influence pregnancy outcomes. In your case, having two fibroids of approximately 4.5 cm each may pose some risks, such as restricted space for the growing fetus, potential for increased uterine contractions, or even complications during delivery. The bleeding you are experiencing could be attributed to several factors, including the normal changes that occur in the uterus during early pregnancy, the presence of fibroids, or other conditions such as cervical polyps.

The first recommendation is to maintain close monitoring of your pregnancy. Regular ultrasounds can help assess the growth of the fetus and the fibroids. If the fibroids are not causing significant complications, many healthcare providers will recommend a watchful waiting approach. This means that you would continue your pregnancy while being monitored for any changes or complications. It is also crucial to maintain open communication with your healthcare providers, as they can provide tailored advice based on your specific situation.

In terms of managing your concerns about the fibroids affecting fetal growth, it is essential to understand that while fibroids can potentially limit space, many women with fibroids have healthy pregnancies and deliver healthy babies. The body is quite adept at accommodating the growing fetus, even in the presence of fibroids. However, if the fibroids cause significant discomfort, pain, or complications, your healthcare provider may discuss treatment options.

If you are considering delaying pregnancy until after treating the fibroids, it is essential to weigh the pros and cons. Surgical options for fibroid removal, such as myomectomy, are available but typically recommended only if the fibroids are causing significant issues. If you choose to wait, it is advisable to consult with a specialist in reproductive health to discuss the best timing for treatment and future pregnancy.

In summary, while the presence of fibroids during pregnancy can raise concerns, many women successfully navigate this situation with proper monitoring and care. It is crucial to follow your healthcare provider's recommendations, maintain regular check-ups, and address any symptoms or concerns as they arise. If you feel uncertain about your current management plan, seeking a second opinion from a maternal-fetal medicine specialist may provide additional reassurance and guidance. Remember, each pregnancy is unique, and your healthcare team is there to support you through this journey.

Similar Q&A

Risks and Precautions for Pregnant Women with Uterine Fibroids

My wife (30 years old) has uterine fibroids and is three months pregnant. Over the past three months, aside from typical morning sickness, she frequently experiences abdominal pain. We have consulted two doctors; the first doctor advised us not to worry about the abdominal pain, ...

Dr. Zhan Deqin reply Obstetrics and Gynecology
The impact of uterine fibroids depends on their location and size. If the fibroids are large enough to compress the cervix or birth canal, they can certainly have an effect. However, if they are not, then there is usually no concern. If there is severe abdominal pain or bleeding,...

Managing Uterine Fibroids and Endometriosis: What You Need to Know

Four years ago, I underwent laparoscopic surgery for endometriosis due to habitual menstrual pain. Recently, the menstrual pain has recurred, and a vaginal ultrasound revealed a 4 cm fibroid in the uterus. I am considering artificial insemination but am unsure whether it would be...

Dr. Wei Fumao reply Obstetrics and Gynecology
I apologize for the delay due to a computer malfunction. Endometriosis can lead to dysmenorrhea and infertility, while uterine fibroids, if large enough to severely compress the uterine cavity, can also cause infertility. If pregnancy is not desired, it is advisable to monitor wh...

Understanding Myoma: What to Know About Fibroids During Pregnancy

It's been a long time, about a year and eight months, right? I'm back because I'm pregnant again. The baby should be about 6 weeks along. 1. Last week, I had an ultrasound, and the doctor said there is a 2 cm fibroid. What is that? Will it cause any problems? 2....

Dr. Zhan Deqin reply Obstetrics and Gynecology
I'm glad to hear that you have adenomyosis, which is caused by the growth of endometrial cells into the muscular layer of the uterus, usually resulting in smaller lesions. Fibroids, on the other hand, are caused by the smooth muscle fibers of the uterus and can grow quite la...

Understanding Uterine Fibroids: Impact on Fertility and Surgery Considerations

I have a question. My period was delayed for two weeks, and after seeing a doctor and having an ultrasound, I was told that I have a tumor about 10 centimeters in size, but I am not pregnant. The doctor said it is a uterine fibroid. Since I plan to get married at the end of next ...

Dr. Li Guanghan reply Obstetrics and Gynecology
Hello: If uterine fibroids are asymptomatic (no excessive menstrual bleeding, abdominal pain, frequent urination, frequent bowel movements, back pain, or thigh numbness), monitoring is sufficient. Uterine fibroids have a minimal impact on the likelihood of pregnancy. Hsinchu City...