Uterine fibroids can increase the risk of some pregnancy complications such as preterm delivery and
obstructed labour. Hence, effective management of uterine fibroids is essential before and during
pregnancy to ensure maternal and foetal health.
Understanding Uterine Fibroids
Uterine fibroids are non-cancerous growths that develop in or on a woman’s uterus. These growths, composed of muscle and fibrous tissue, are common, especially in women of reproductive age. While the cause of uterine fibroids remains unknown, they have been linked to hormonal, genetic, or other growth factors.
Common Symptoms of Fibroids
Uterine fibroids often do not present symptoms but when they do, symptoms may include:
- Pelvic Discomfort or Pain: This feeling of unease or pain in the pelvic area may be due to fibroids pressing against surrounding organs, or cramping.
- Digestive Issues: The pressure from fibroids can cause problems with digestion, such as constipation and bloating.
- Back Pain: Fibroids pressing on the nerves in the lower back can cause back pain.
- Frequent or Uncomfortable Urination: When fibroids press against the bladder, they can cause frequent or uncomfortable urination.
- Pain During Intercourse: Fibroids near the cervix or lower uterus can cause discomfort.
Uterine Fibroids During Pregnancy
Although fibroids usually do not cause significant issues during pregnancy, large or multiple fibroids can sometimes increase the risk of certain complications, including:
- Pregnancy Loss: Larger or multiple fibroids can increase the risk of miscarriage, especially in the first trimester.
- Placental Abruption: Large fibroids can interfere with the attachment of the placenta or cause it to detach prematurely.
- Placenta Previa: This condition occurs when the placenta attaches too low in the uterus, covering the cervix. This can lead to heavy bleeding during late pregnancy.
- Foetal Growth Restriction: Large fibroids can limit space for the baby to grow, leading to potential restricted foetal growth.
- Preterm Delivery: Fibroids can irritate the uterus leading to premature contractions or labour, which poses risks to the baby should preterm delivery be inevitable.
- Postpartum Haemorrhage: Fibroids can affect the ability of the uterus to contract effectively after delivery, increasing the risk of postpartum bleeding.
- Malpresentation: Large fibroids can cause abnormal positioning of the foetus within the uterus, preventing the baby from assuming the optimal position for birth.
Treating Uterine Fibroids
Management and treatment for uterine fibroids are limited during pregnancy to reduce risks to the foetus. Obstetricians and gynaecologists typically recommend the following:
- Regular Monitoring: Regular check-ups can help track fibroid growth, preventing potential complications early.
- Pain Relief: Over-the-counter pain relievers can help with cramps and discomfort associated with fibroids.
- Hormonal Therapies: Medications like gonadotropin-releasing hormone (GnRH) agonists may help to shrink fibroids and reduce bleeding.
- Myomectomy: In a few cases, a myomectomy (surgical fibroids removal) may be performed during the second half of pregnancy.
Delivery and Postpartum Care
Pregnant women with uterine fibroids can and often do experience uneventful pregnancies and successful deliveries. The choice of delivery method and careful postpartum care can help to manage potential complications associated with fibroids.
Delivery Options
The suitable delivery method for pregnant women with fibroids will generally depend on the size and location of fibroids, the baby’s position, as well as overall maternal and foetal health.
- Vaginal Delivery: If the fibroids are small and not causing major complications, vaginal delivery may be considered.
- Caesarean Section: This may be necessary when the fibroids are large or positioned in a way that may obstruct the birth canal or cause foetal distress.
Postpartum Care and Monitoring
Postpartum care is essential for careful monitoring for excessive bleeding, uterine contractions, and any signs of infections. Seek immediate medical assistance if any complications arise.
