Fibroids and Pregnancy
If you are pregnant, you have likely already gone for a pelvic exam or ultrasound examination. These exams help your health care provider get an idea of the health of your uterus and baby. During these exams, many pregnant women discover that they have uterine fibroids. These masses, which grown in or on the uterus, are typically harmless and cause few complications. Occasionally, however, uterine fibroids can cause problems during pregnancy, so it is a good idea to find out more about their growth.
What are Uterine Fibroids?
Uterine fibroids are large masses made up of tissue cells from your uterus. Actually a type of non-cancerous tumor, fibroids can grow in and around your uterus, distorting the shape and size of this organ. Fibroids typically range in size, from just a few centimeters in length to up to 15 centimeters or more. Fibroid tumors often grow in clusters, so if you have one uterine fibroid, it is likely that you may also have more.
Fibroids are actually quite common - between 50% and 80% of all women have at least one. For the most part, these fibroids cause no symptoms, though they can be problematic for about 20% of women. Between 10% and 30% of pregnant women also have fibroids. Uterine fibroids are usually discovered during your annual pelvic exam.
Types of Uterine Fibroids
There are three types of uterine fibroids, classified according to where they grow in your uterus.
- Intramural: Intramural fibroids grow inside the wall of your uterus. They are the most common type of fibroids.
- Subserosal: Subserosal fibroids grow on the outside of the uterus, and can swell to large sizes. Sometimes these fibroids grow on a stalk and reach out towards other organs.
- Submucosal: Submucosal fibroids grow inside the uterus. They account for only 5% of all uterine fibroids.
Who Gets Uterine Fibroids?
Uterine fibroids can affect any woman at any age. In fact, if your health care provider looked hard enough, she could probably find a small fibroid in pretty much any woman. However, certain women are at increased risk of developing uterine fibroids. Women between the ages of 20 and 50 are more likely to develop larger fibroids. Women of African descent are also more likely to develop fibroids.
Causes of Uterine Fibroids
You are probably wondering why your fibroids started growing in the first place. Well, there is no clear consensus as to why fibroids develop. Some women may simply have a genetic predisposition to growing fibroids. Fibroids may also be the result of hormones. Reproductive hormones like estrogen and progesterone can stimulate cell growth, causing fibroids to form. During pregnancy, your influx of hormones may cause your fibroids to grow in size. After pregnancy and during menopause most fibroids begin to shrink, due to a lack of hormones.
Symptoms of Fibroids
For the large majority of women, fibroids cause no symptoms or side effects. Many women don’t even know that they have fibroids until they become pregnant. However, large fibroids may cause some uncomfortable symptoms. Possible symptoms include:
- prolonged periods
- heavy bleeding
- pain during intercourse
- constipation or bloating
- pain in the legs or back
- pelvic pain or pressure
Complications of Fibroids During Pregnancy
Though fibroids tend to grow in size during pregnancy, it is unlikely that they will cause you any symptoms. Some pregnant women do experience minor symptoms, particularly pelvic pain and light spotting. This is especially common if you experience fibroid torsion, when a fibroid growing on a stalk begins to twist. However, most pregnant women will not even know that the fibroids are there.
Most pregnant women who have fibroids will not experience any complications with their pregnancy either. However, fibroids during pregnancy do increase your risk of miscarriage or preterm labor slightly. Occasionally, complications can arise if your fibroids become very large. Complications can include:
- postpartum hemorrhaging
- obstructed labor (if the fibroid grows into the birth canal)
- fetal malpresentations (sometimes fibroids grow into the uterus, forcing your baby into an unusual position)
- stalled labor
- cesarean section
During pregnancy, it is recommended that you not seek any treatment for your fibroids. Your health care provider will monitor the growth of your fibroids in order to anticipate any complications. If you are experiencing pain, try lying down or using an ice pack to numb the area. Immediate treatment may be pursued if you begin to bleed profusely or experience severe pain.
After pregnancy, fibroids tend to shrink in size, and probably won’t cause you any problems. If you are still suffering from symptoms, treatments are available for fibroids. Treatments include:
- ablation of the fibroids
- surgery to remove the fibroids
- medications to shrink the fibroids