Uterine fibroids and pregnancy

The article was consulted professionally by Master, Dr Trinh Thi Thanh Huyen – Obstetrics and Gynecology Department – Share99 Hai Phong International Health Hub.

Fibroids are tumors that grow from muscle tissue in the uterus. This is a benign tumor. The size of fibroids can be as small as peas or larger than grapefruits. They can grow outside the body, inside the uterus cavity or inside the body. Many women have multiple fibroids of different sizes.

It is estimated that 40% to 60% of women have fibroids at the age of 35. Up to 80% of women have uterine fibroids by the age of 50. But the discovery of uterine fibroids during pregnancy is not always easy. That's because it is difficult for doctors to diagnose fibroids due to the thickening of the muscles of the uterus that occur during pregnancy. For this reason, doctors claim that the number of cases of uterine fibroids during pregnancy is known to be lower than the actual number.

Most women diagnosed with fibroids are pregnant normally, but sometimes tumors can cause serious conditions for pregnant mothers.

Most fibroids do not develop when you are pregnant, but if this happens then usually the tumor will develop in the first 3 months of pregnancy. That's because fibroids need a hormone called estrogen to grow. Your body produces more of these hormones when you are pregnant.

Uterine fibroids can cause a number of problems when you are pregnant, including:

• Bleeding and pain. In a study of more than 4,500 women, researchers found that 11% of women with uterine fibroids also had bleeding and 59% only had pain. But about 30% of women suffer from bleeding and pain during the first tri tri month of pregnancy.
• Miscarriage. Women with fibroids are more likely to miscarry in the early part of pregnancy than non-pregnant women. And if you have more uterine fibroids, the risk of miscarriage increases even more. The risk of miscarriage in cases of uterine fibroids is 2 times higher than for those who do not.
• It hurts. This is the most common symptom of fibroids, especially when the size of the tumor is growing. Uterine fibroids can cause stomach pain. In some cases, it can lead to miscarriage and premature calving. Over-the-counter medications such as acetaminophen (Tylenol) can relieve your pain. But avoid ibuprofen (Advil) early in pregnancy and during the third trimemep. This can cause miscarriages.
• Premature birth. If you have fibroids, you will likely give birth prematurely – meaning that your baby is born before 37 weeks of pregnancy, compared to women who do not have fibroids. Pain caused by fibroids can lead to uterine contractions, which can lead to premature birth.
• Limit fetal growth : Large fibroidscan prevent the fetus from fully developing due to reduced area in the womb.
• Placenta peeling: This happens when the placenta peels off the walls of the uterus because it is blocked by a fibroid. This reduces oxygen and nutrients important for feeding the fetus.
• Cesarean section: According to some studies, it is estimated that women with fibroids are about 6 times more likely to need a cesarean section than women who do not have uterine fibroids.
• Reverse star: Due to the abnormal shape of the uterus, it is possible to form an inverted fetus.

Some of the most common symptoms of uterine fibroids include:

• sick
• bleed
• Anemia caused by severe or long-term bleeding
• Feeling mild pain in the lower abdomen
• Pain during sex
• Lumbar pain
• constipation
• Birth problems, including infertility, miscarriage and premature birth
• Frequent urination
• Urinary difficulties

If your doctor suspects you have a tumor that develops, you will be asked to perform an imaging test, such as an ultrasound , to accurately diagnose the condition.

Fibroids usually shrink after childbirth. In one study, researchers found that, between 3 and 6 months after birth, 70% of women saw their fibroids shrink by more than 50% compared to the pre-childbirth period.

During pregnancy, the treatment of uterine fibroids is limited due to the possible risk to the fetus. Your doctor will prescribe you to rest in bed, hydrate and take mild painkillers to help future mothers manage the symptoms of fibroids.

In rare cases, the doctor will perform surgery to remove the fibroid in the second half of pregnancy if the uterine fibroid is large, the fibroid is lower peritoneal and affects the fetus. This procedure removes fibroids from outside the uterus or from the inside of the uterine city while retaining the uterus. Fibroids that develop in the uterine cavity are usually not in order to perform this procedure due to the possible risks to the fetus.

In addition, if fibroids are detected before pregnancy, the most common treatments to preserve fertility include:

• Surgical removal: This surgical procedure is used to remove fibroids. It can increase the likelihood of cesarean section and you will probably have to wait about three months after the procedure before pregnancy.
• Ormonal contraceptives : While youare taking the contraceptive pill, you will not be able to get pregnant. This contraceptive can help alleviate symptoms caused by fibroids, such as severe and painful bleeding.
• Contraceptive Ring (IUD): Like the contraceptive pill, the IUD will help you contraceptive as long as you are using it. However, it can help eliminate some of the symptoms caused by fibroids while preserving fertility.
• Gonadotropin-releasing hormone analogues (Gn-RH): This drug prevents the production of hormones that lead to ovulation and menstruation, so you will not be able to get pregnant while taking this drug. It can help shrink fibroids.
• Shrink blood vessels: Usean electric current, laser or radio frequency energy beam to shrink the blood vessels that feed the fibroids.

Each treatment has its own risks and complications, so it is advisable to consult a doctor before deciding on a fibroid treatment.

You should consult your doctor about how long you will have to wait after treatment to be ready for pregnancy. With some treatments, such as contraceptive pills, if you want to get pregnant then you can stop using it.

Uterine fibroids can affect your fertility and ability to successfully get pregnant. However, most women will not experience birth problems or pregnancy complications as a result of these tumors.

If you have fibroids and want to get pregnant, talk to your doctor about the appropriate treatment options and the risks that may be encountered to make the most reasonable, safest decision for your later pregnancy.

To register for examination and treatment at Share99 International Health Hub, you can contact Share99 Health System nationwide, or register for an online examination HERE.

Master. Dr. Trinh Thi Thanh Huyen is highly trained in obstetric ultrasound, laparoscopic surgery and endoscopy at the National Health Hub of Obstetrics and Gynecology and has more than 13 years of experience working at Hai Phong Obstetrics and Gynecology Health Hub.

Currently, the doctor is a doctor of obstetrics and gynecology at Share99 Hai Phong International Health Hub

Reference source: Webmd.com; Healthline.com