Fibroids During Pregnancy – 4 Types, 12 Symptoms & 5 Treatments You Should Be Aware Of
Uterine fibroids are a common condition among women. They have no serious repercussions except for the discomfort and pain that they cause with their presence in the female reproductive tract.
Fibroids can occur at any time from pre-puberty to old age. Though their exact cause is unknown, studies point to the female hormones that control the periods, particularly estrogen to cause the growth.
What Are Fibroids?
Uterine fibroids, also referred to as leiomyoma or myoma of uterus, are non-cancerous tumors that grow abnormally in the uterine region.
- The size of fibroids can be anything from that of a pea to a large ball.
- They usually develop after the commencement of menstrual cycle.
- In most cases, sudden fibroids appear in the uterine cavity out of nowhere, calling for medical attention.
[ Read: Listeriosis During Pregnancy ]
Who Gets Fibroids?
Although there are no concrete factors proved to trigger a fibroid growth, below are some factors that make women susceptible to them. Fibroids are more common among:
- Women around 35 years of age.
- Women who are overweight or obese.
- Women who are not on contraceptive pills or injection.
During pregnancy too, there is a possibility to develop fibroids. If you are planning to conceive or are already pregnant, read ahead to understand more about fibroids during pregnancy and their symptoms to avoid any delay in treating them.
[ Read: Yeast Infection During Pregnancy ]
Types Of Fibroids During Pregnancy:
There are different kinds of fibroids based on the location where they sprout from in the uterine region:
1. Intramural Fibroids:
These fibroids are the most common types that grow within the muscle wall of the uterus.
- Intramural fibroids tend to grow large in size, making the uterus full.
- This further causes heavy bleeding during periods or even inability to conceive as they obstruct egg from being fertilized.
2. Submucosal Fibroids:
These fibroids grow under the inner lining of the uterus known as endometrial lining.
They cause heavy and painful periods along with fertility problems.
[ Read: Protein In Urine During Pregnancy ]
3. Subserosal Fibroids:
These fibroids grow on the outside of the uterus, stretching into the pelvis.
- Subserosal fibroids tend to put additional strain on the bladder, causing bowel related issues.
- Both submucosal and subserosal fibroids grow from a stalk like structure, sometimes sticking out of the uterus into the pelvic area.
[ Read: Pelvic Pain During Pregnancy ]
4. Cervical Fibroids:
As the name suggests, these fibroids grow in the neck of your cervix.
Symptoms Of Uterine Fibroids:
Knowing the definite pattern of signs and symptoms will enable you to consult your gynecologist, who will perform further tests to rule out the possibility of fibroid formation. Below are some of the symptoms:
- Painful periods
- Vaginal bleeding
- Cramping
- Heavy blood loss that lasts for days together
- Urge to rush to the bathroom often
- Pain while urinating
- Fullness of abdomen that causes extra pressure and constipation
- Back pain
- Pelvic pain
- Abdominal pain
- Trouble getting pregnant
- Frequent unexplained miscarriages
[ Read: Endometriosis And Pregnancy ]
Diagnosis For Uterine Fibroids:
Once your doctor is informed about the above symptoms, he or she will diagnose the presence of fibroids with the below tests:
- An ultrasound scan to examine the inside of your uterus
- The doctor will check for the presence of any lumpy structures or abnormality in the shape of your uterus.
- Once the initial doubt is confirmed, hysteroscopy is performed, where your doctor will check the inside of your uterus with more detail.
- During this procedure, a viewing tube is inserted into your vagina. Hysteroscopy usually detects the submucosal fibroids very easily.
Invasive Diagnostic Method:
Laparoscopy may be needed if your doctor decides that it needs to be done, to get the best picture of your problem.
- Subserosal fibroids are located easily with a laparoscopy.
- This is a procedure during which you will be given a general anaesthesia. Your doctor will make a tiny incision below the navel.
- A tube having a tiny camera is inserted via the incision to get a detailed look at the pelvic region.
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Should Fibroids Be Treated?
The fibroids are not required to be removed unless they are seriously interfering with your routine, causing pain and discomfort.
- If you are already pregnant and the fibroids are fast growing inside, it is stated that pregnancy itself will minimize the growth.
- The more number of pregnancies you have, the lesser are the chances for the fibroids to develop.
Treatment During And After Pregnancy:
If you are already in the vicious trap of symptoms such as heavy menstrual bleeding, pain and difficulty in conceiving, you can insist your doctor to explain to you, the different treatments that are available for fibroids.
The final call will be taken by your health care provider looking at the seriousness of the condition. The main forms of fibroid during pregnancy treatment available are as below:
1. Hormone-Balancing Drugs:
Drugs that release a hormone called gonadotrophin may be prescribed. This hormone acts like a counteroffensive to your estrogen levels, reducing the production and thereby limiting the possibility of more fibroids growing.
- Gonadotrophin based drugs also help in shrinking the size of the existing fibroids.
- These drugs, also known as GnRHas are either prescribed in the form of injection, nasal spray or implants that are placed under your skin.
- GnRHas drugs have heavy side effects that result in hot flashes, dry vagina and weaker bones. Hence these are given over a long stretch of 3 to 6 months.
2. Myomectomy:
This is a surgical procedure that is used to remove the fibroids via operation. During this procedure, a surgery is performed with the help of laparoscopy or hysteroscopy.
- The recovery time from a myomectomy largely depends on the size of the fibroids removed.
- For larger fibroids, the period to recover is quite long where after you will be recommended a strict bed rest for many number of days.
- Myomectomy is highly useful for women who are seriously planning to conceive and have children. However, there is no guarantee that fibroids will not grow back again.
3. Endometrial Resection Or Ablation:
An endometrial resection or ablation is a non surgical process. This procedure is largely used for the treatment of submucosal fibroids that grow in the inner lining of the uterus.
- During this process, the endometrial tissue from the inner lining is surgically removed, in the area where the fibroid is growing.
- After the completion of treatment, women can try conceiving again.
4. Myolysis:
Myolysis is a procedure that is carried out with a keyhole surgery using a laparoscope or hysteroscope.
- A sonogram or MRI is then used to detect the exact position of the fibroid.
- The surgeon will then insert a needle probe or electric current into the fibroid to cauterise both the fibroid and the surrounding blood vessels.
5. Uterine Artery Embolisation (UAE):
This process is performed by an experienced radiologist, who will use the magnetic resonance imaging (MRI) scan to detect the location of the fibroid.
- The MRI will also show a clearer view of all the blood vessels surrounding the fibroid.
- The radiologist will then inject a plastic plug into the blood vessel to cut off the blood supply to the growing fibroid.
- This is an effective procedure where fibroids are shrunk completely. This procedure also cannot guarantee that fibroids will never return again.
- Most women may have to repeat the procedure after few years once there is another onset.
- Unlike myomectomy or endometrial resection, UAE does not guarantee as whether women who undergo the process will conceive again.
Uterine Fibroids And Pregnancy:
The chances of getting pregnant depend directly on the type of fibroid that you have. Below are the possibilities of conception with different types of fibroids.
- Submucosal fibroids directly affect the ability to conceive as they distort the entire uterus, thereby disturbing the implantation of the embryo even after fertilization.
- The sooner you try to conceive, the lesser are the chances of infertility due to fibroids or even the occurrence of the fibroids.
- If your doctor feels that the presence of a fibroid is affecting your plans to conceive, he or she may recommend you to try conceiving for up to two more years.
- If you are over 34, chances of conceiving become lower. This is the instance where your doctor will recommend treating the fibroid through any of the above options except UAE.
Fibroids And Your Unborn Baby:
You may have anxieties as to whether the fibroids will affect the growing baby during pregnancy.
- They will not affect your baby directly, although the chances of miscarriage or preterm labor increase because of the presence of fibroids.
- Sometimes, fibroids will affect the position of the baby right before the delivery.
- The cervical fibroids can also stall the labor, causing complications that may force your doctor to opt for a cesarean delivery.
[ Read: Complications During Pregnancy ]
Tips And Caution:
Your doctor will mostly put you on bed rest and medications for uterine fibroids while pregnant.
- Also, you will constantly check throughout your pregnancy, via ultrasound, to see how the fibroids present themselves from time to time.
- A necessary course of action will be taken by your doctor if he or she feels that there is an immediate threat to your pregnancy because of the fibroid.
- It is indeed an uncomfortable condition to have, but do not worry – there are many options available to treat fibroids. We hope this article has given you the info on such options and makes your decision a little easier.
Do share your experience on how you dealt with fibroids in pregnancy, in the section below.
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