Will having uterine fibroids affect pregnancy? What are the symptoms of uterine fibroids?

Uterine fibroids are common in women of childbearing age, so the impact of uterine fibroids on pregnancy and pregnancy on fibroids is a very worrying issue for women of childbearing age. Because every woman has the desire to become a mother, will uterine fibroids affect pregnancy? The following is an introduction to this issue:

1.Does uterine fibroids affect pregnancy?

Most women who have uterine fibroids before pregnancy can successfully go through the entire pregnancy period, but as the pregnancy weeks increase, the fibroids increase significantly. A few may experience the following: if the fibroids are large and the pregnancy increases significantly, red degeneration may occur, abdominal pain (mostly seen when the fibroid diameter exceeds 3cm), fever and other symptoms may occur, and even miscarriage and premature birth; if the fibroids affect the uterine morphology, abnormal fetal position may occur; if the fibroids are submucosal and the placenta is attached to the surface of the fibroids, placental abruption may occur. After delivery, more than 90% of fibroids will shrink back to their pre-pregnancy state within 3-6 months after delivery.

It is generally believed that: fibroids growing inside the uterus (submucosal fibroids) affect pregnancy; fibroids growing in the myometrium (intramural fibroids) are small and have a greater impact; fibroids growing outside the uterus generally do not affect pregnancy; if the fallopian tubes grow and compress the fibroids near the fallopian tubes, they may also affect pregnancy.

2. Which patients with uterine fibroids need surgery before pregnancy?

For expectant mothers with uterine fibroids who are preparing to have a child, it is recommended to remove the fibroids before pregnancy if they have the following conditions:

(1) Submucosal fibroids;

(2) Intramural or subserosal fibroids larger than 4 cm (the main consideration is that large fibroids will grow rapidly during pregnancy and may undergo red degeneration, causing abdominal pain, premature birth, etc., which may affect the continuation of pregnancy);

(3) Infertility may be caused by fibroids, excluding other causes.

3. Adverse effects of pregnancy on uterine fibroids

Possible complications during pregnancy:

(1) Submucosal uterine fibroids affect embryo implantation and placenta formation, leading to miscarriage or even infertility.

(2) As the gestational age increases, uterine fibroids increase rapidly, and ischemic degeneration and necrosis occur in the center of the fibroids. Pregnant women experience localized abdominal pain accompanied by fever, nausea, vomiting, and increased blood count.

(3) If the placenta is attached to the fibroid, the probability of bleeding and abruption during pregnancy will increase.

(4) Multiple fibroids can affect the contractility of the uterus and increase the risk of premature birth. During delivery, contractions may also be uncoordinated. Contractions require increased contractions, increasing the risk of poor contractions and bleeding after delivery.

(5) Large uterine fibroids can restrict pelvic space, affect fetal growth and development, and lead to limited intrauterine growth and abnormal fetal position.

4. Which pregnant women need cesarean section?

If a pregnant woman with uterine fibroids has a normal fetal position and labor is progressing well, and the uterine fibroids do not affect the birth canal, the progress of labor can be closely observed and vaginal delivery can be performed.

If the fetal position is abnormal, or the trial labor process is stagnant, uterine fibroids block the soft birth canal and affect the descent of the fetal head, a cesarean section will be required to terminate the pregnancy.

For pregnant women with a history of myomectomy, vaginal delivery is possible if the fibroids are small or subserosal; if the removed fibroids have penetrated the endometrium in large quantities or are close to the uterine cavity, especially on the posterior wall of the uterus, a planned cesarean section is recommended after fetal maturity in late pregnancy to reduce the risk of uterine rupture. Therefore, the record of previous myomectomy is very important for obstetricians to assess risk.

5. Can myomas be removed at the same time during cesarean section?

Many people think that I have uterine fibroids, so I choose cesarean section directly, and then the fibroids can be removed after delivery during surgery. In fact, during pregnancy, the uterus is rich in blood supply, and additional surgery will increase bleeding. The uterus may be removed to rescue hemorrhagic shock. Therefore, only when the growth site of the fibroid affects fetal delivery and incision suture, can the uterine fibroids in the corresponding site, as well as the subserous uterine fibroids and other easily resectable fibroids be removed at the same time. Multiple fibroids and large intramural fibroids are generally not performed at the same time, and whether surgery is necessary is determined based on the size and symptoms after delivery.