Pregnancy with Uterine Fibroids: Risks, Changes, and Management Options

Q: Pregnancy with Uterine Fibroids: Risks, Changes, and Management Options

Hello： 1. <br>There is a 1/3 chance that the fibroid will increase in size, a 1/3 chance that it will remain the same size, and a 1/3 chance that it will decrease in size. <br>2. <br>There is no significant risk to life; most cases can be delivered vaginally, and only a small num

Pregnancy with Uterine Fibroids

Hello: Previously, my wife was diagnosed with a 10x7 cm uterine fibroid growing towards the back of the uterus.
Some doctors suggested that she should undergo surgery to remove it before trying to conceive, while others believed that there is a risk of adhesions from the surgery and recommended that she should get pregnant first and then address the fibroid.
We ultimately chose the latter option and are currently 5 weeks pregnant.
However, due to the fibroid, her abdomen has already protruded to about the size of 20 weeks.
The doctor mentioned that the later stages of pregnancy might be quite challenging and advised us to decide whether to remove the fibroid.
We are feeling quite uncertain and would like to ask the doctor: 1.
What changes can we expect in the fibroid during the pregnancy? Will it continue to grow? (Currently, the abdominal protrusion seems more pronounced.) 2.
What impact will the fibroid have on the mother and the fetus during the pregnancy? Is there any risk to the mother's life? 3.
What is the likelihood of miscarriage or preterm birth? 4.
Can the pain during this process be managed or controlled with medication?

tmhuang, 30~39 year old female. Ask Date: 2005/10/25

Dr. Li Guanghan reply Obstetrics and Gynecology

Hello: 1.
There is a 1/3 chance that the fibroid will increase in size, a 1/3 chance that it will remain the same size, and a 1/3 chance that it will decrease in size.
2.
There is no significant risk to life; most cases can be delivered vaginally, and only a small number may require a cesarean section if the position of the fibroid is determined to obstruct the birth canal at term.
3.
The likelihood is low.
4.
There is a 1/3 to 1/2 chance that the fibroid may undergo a benign change known as red degeneration during pregnancy, which can cause pain; appropriate use of pain relief medication can alleviate this.
Conclusion: Do not decide to terminate the pregnancy solely because of the presence of fibroids.
Hsinchu City Hospital, Department of Obstetrics and Gynecology.

Reply Date: 2005/10/25

More Info

Pregnancy with uterine fibroids can present a unique set of challenges and considerations for both the mother and the developing fetus. Uterine fibroids, also known as leiomyomas, are benign tumors that can vary in size and location within the uterus. In your case, a 10x7 cm fibroid located posteriorly in the uterus raises several important questions regarding its management during pregnancy.

1. Changes in Fibroids During Pregnancy: During pregnancy, fibroids can undergo changes due to hormonal influences, particularly from estrogen and progesterone. Many fibroids may grow in size during the first trimester due to increased blood flow and hormonal stimulation. However, some fibroids may remain stable or even shrink after the first trimester. It is essential to monitor the fibroid's size and any associated symptoms throughout the pregnancy. Regular ultrasounds can help track these changes.

2. Impact on Mother and Fetus: The presence of fibroids can potentially lead to complications for both the mother and the fetus. For the mother, large fibroids can cause discomfort, pressure symptoms, or complications such as pain, urinary frequency, or constipation. In some cases, they may lead to complications during labor, such as obstructed labor if the fibroid obstructs the birth canal. For the fetus, the primary concern is the potential for restricted space in the uterus, which could affect fetal growth and positioning. However, many women with fibroids have successful pregnancies and deliver healthy babies.

3. Risk of Miscarriage or Preterm Birth: The risk of miscarriage or preterm birth associated with fibroids varies depending on their size, location, and number. Generally, larger fibroids (especially those that distort the uterine cavity) may be associated with a higher risk of complications. Studies suggest that while the overall risk of miscarriage is not significantly increased in women with fibroids, certain types of fibroids, particularly submucosal fibroids, may pose a higher risk. The risk of preterm birth may also be slightly elevated, particularly if the fibroids are large or if there are other complicating factors.

4. Pain Management and Control: If the fibroid causes significant discomfort or pain during pregnancy, it is crucial to discuss pain management options with your healthcare provider. Over-the-counter pain relievers like acetaminophen are generally considered safe during pregnancy, but nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided, especially in the third trimester. Your doctor may also recommend other non-pharmacological approaches to manage pain, such as physical therapy, heat application, or relaxation techniques.

In conclusion, while the presence of a large fibroid during pregnancy can pose challenges, many women successfully navigate these issues with appropriate monitoring and care. It is essential to maintain open communication with your healthcare provider, who can tailor a management plan based on your specific situation. Regular prenatal visits will help ensure that both you and your baby remain healthy throughout the pregnancy. If you experience any concerning symptoms, such as severe pain, heavy bleeding, or signs of preterm labor, seek medical attention promptly.

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,...

Understanding Uterine Fibroids: Treatment Options and Dietary Tips

Hello Dr. Huang, I have just been diagnosed with a possible uterine fibroid, the largest measuring approximately 8.6 cm x 9.7 cm x 7.2 cm. Could you please advise me on the treatment options available? I am unmarried but planning to marry my fiancé this year and we are also prepa...

Dr. Huang Jianxun reply Obstetrics and Gynecology
Hello: When uterine fibroids average larger than 5 cm, statistics indicate that the chances of becoming pregnant increase, as do the risks of miscarriage and complications during delivery. If the location of the fibroids affects future pregnancy progress, consideration may be giv...

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...

Managing Uterine Fibroids: Non-Surgical Options and Treatment Insights

Dear Dr. Lin, I have three fibroids in my uterus, each approximately 2 to 3 centimeters in size. I am currently managing them with medication (progesterone, taken for two months), but over the past month, I have experienced a significant increase in menstrual blood flow accompan...

Dr. Lin Manying reply Obstetrics and Gynecology
Hello: Fibroids are common benign tumors of the uterus. Although 40% are asymptomatic, those who do experience symptoms often report heavy menstrual bleeding with clots, abdominal pain, a feeling of heaviness, and pressure. However, before confirming surgery or treatment, it is e...