How Do Uterine Fibroids Affect Pregnancy?
Uterine fibroids—noncancerous growths that form in or on the uterus—are more common than many people think. Affecting up to 80% of women by age 50, these growths often go unnoticed. But for those who are pregnant or trying to conceive, fibroids can raise important questions about fertility, complications, and safe delivery. Here’s what you need to know.
What Are Uterine Fibroids?
Fibroids (also known as leiomyomas or myomas) are benign tumors that grow from the muscle tissue of the uterus. They vary in size, number, and location. Some may be as small as a pea; others can grow as large as a melon.
Types of fibroids based on location:
- Intramural: Grow within the uterine wall
- Submucosal: Bulge into the uterine cavity
- Subserosal: Project outside the uterus
- Pedunculated: Attached to the uterus by a stalk
Can You Get Pregnant With Fibroids?
Yes, many women with fibroids conceive naturally and have healthy pregnancies. However, certain types—especially large or submucosal fibroids—may make it harder to conceive by:
- Blocking the fallopian tubes
- Interfering with implantation of the embryo
- Altering the shape of the uterine cavity
If you're having trouble getting pregnant and have fibroids, a fertility specialist may recommend imaging (like ultrasound or MRI) and possible removal before trying IVF or other treatments.
How Do Fibroids Impact Pregnancy?
Most women with fibroids have normal pregnancies. But depending on the size, location, and number of fibroids, complications can occur:
1. Pain and Discomfort
As fibroids grow, especially in early pregnancy due to increased estrogen, they can cause sharp pain or pressure in the lower abdomen. This is most common with rapidly growing or degenerating fibroids.
2. Miscarriage Risk
Studies suggest that women with large fibroids—especially those that distort the uterine cavity—may have a slightly higher risk of first-trimester miscarriage.
3. Placental Issues
- Placenta previa: The placenta may implant near or over fibroids, leading to complications
- Placental abruption: Fibroids behind the placenta may increase the risk of detachment
4. Fetal Growth Restriction
Large fibroids can reduce space in the uterus or disrupt blood flow to the placenta, affecting the baby's growth. However, this is rare.
5. Preterm Labor
Fibroids may trigger uterine contractions, increasing the risk of preterm labor or early delivery in some cases.
How Are Fibroids Managed During Pregnancy?
Most fibroids are managed conservatively during pregnancy, meaning they are monitored but not treated unless absolutely necessary. Treatment typically includes:
- Regular ultrasounds to track growth and location
- Pain relief with acetaminophen (avoiding NSAIDs unless approved)
- Hydration and rest to ease pressure and cramping
Surgical removal (myomectomy) is generally avoided during pregnancy due to high bleeding risk unless life-threatening complications arise.
Can You Deliver Naturally With Fibroids?
It depends on the fibroid’s size and location:
- Small fibroids: Often don’t interfere with labor
- Fibroids near the cervix: May block the birth canal, leading to C-section recommendation
- Multiple fibroids: May impact uterine contractions or increase postpartum bleeding
Many women with fibroids deliver vaginally without complications, but close monitoring is essential.
Postpartum Considerations
Fibroids often shrink after delivery due to lower hormone levels. However, women with fibroids are at slightly increased risk for:
- Heavy postpartum bleeding
- Retained placenta
- Infection or delayed uterine recovery
Follow-up care with your OB-GYN is crucial during the postpartum period.
When to See a Doctor
Consult your doctor if you experience:
- Severe or persistent pelvic pain
- Heavy vaginal bleeding
- Signs of miscarriage or preterm labor
Even if you’ve been diagnosed with fibroids before, you should let your obstetrician know as soon as you become pregnant for personalized monitoring and care.
Key Takeaways
- Most women with fibroids have healthy pregnancies and babies
- Complications depend on fibroid size, number, and location
- Management during pregnancy is typically non-invasive
- Close prenatal care is important for optimal outcomes
If you're pregnant or planning to conceive and have fibroids, don’t panic. With informed care and regular monitoring, a healthy pregnancy and delivery are absolutely possible.
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