Treatment of uterine fibroids in pregnant women

Uterine fibroids are a common symptom among women of childbearing age. The early symptoms of uterine fibroids are not very obvious, and may only be a slight change in menstrual volume, so many female friends do not notice it. Uterine fibroids are often discovered during prenatal checkups during pregnancy. Uterine fibroids can easily cause premature birth or miscarriage, so pregnant women are particularly worried. What should they do if they are found to have uterine fibroids during pregnancy? Let's take a look at how to deal with uterine fibroids in pregnant women.

Treatment of uterine fibroids in pregnant women

1. For women who want to have children, if they are found to have uterine fibroids before pregnancy, they will be treated according to the location, size and whether there are symptoms of the fibroids. If the symptoms significantly affect your health, or the uterine fibroids are large or located under the mucosa, affecting the morphology of the uterine cavity and conception, the doctor will recommend surgery or drug treatment to remove the fibroids or reduce their size, but after treatment most women will need to use contraception for one year before they can become pregnant.

2. But what should I do if I find out I have uterine fibroids after I am already pregnant?

In fact, pregnancy and uterine fibroids affect each other. When pregnancy is complicated by uterine fibroids, the fibroids will affect the uterine cavity to a certain extent, causing deformation of the uterine cavity, lesions in the endometrium, obstruction of the cervical canal, etc. This may hinder the implantation of the fertilized egg and affect the growth and development of the fetus in the uterus, resulting in premature birth, miscarriage, etc. Moreover, as the fibroids continue to grow and compress the uterus, it may also hinder the growth and development of the fetus, causing malposition of the fetus, low-lying placenta or previa, etc. During delivery, if the fibroids block the delivery, it may also prolong the delivery process by reducing the contractility of the uterus. In addition, after delivery, fibroids may cause placental adhesion, difficulty in placental expulsion, uterine atony, etc., which increases the risk of postpartum hemorrhage.

When women are pregnant, they secrete a lot of estrogen and progesterone, which can stimulate the growth of fibroids, causing them to grow rapidly and undergo various degenerations. The main symptom during pregnancy is red degeneration. As the fibroids rapidly grow and become congested, the patient may experience abdominal pain accompanied by fever, which may lead to adverse consequences such as intrauterine fetal death, miscarriage, and premature birth.

3. Whether or not to terminate the pregnancy depends on the specific circumstances

Although uterine fibroids have adverse effects on pregnancy, it is not necessary to terminate the pregnancy once fibroids are discovered. He Xiukui said that whether the pregnancy needs to be terminated depends on the size and location of the fibroids, the month of pregnancy and the specific situation of the patient.

If it is a subserosal fibroid (fibroids that grow outside the uterus), the pregnancy can usually continue. However, if the subserosal fibroid has pedicle torsion and conservative treatment is no longer effective, surgical intervention is required.

If it is intramural fibroids or submucosal fibroids, you should be more cautious. The former is a tumor that grows in the myometrium; the latter is a tumor that grows in the uterine cavity, which is the type of uterine fibroid that has the greatest impact on pregnancy. However, submucosal fibroids affect the morphology of the uterine cavity and often lead to infertility or early pregnancy miscarriage. The impact of intramural uterine fibroids on pregnancy varies depending on the size of the tumor. If the tumor is <5cm, you can observe it first and check it with ultrasound every 3-6 months. As long as the fibroids do not grow significantly, you can continue to be pregnant. However, if the fibroids are large or significantly enlarged, repeated miscarriages may occur. Therefore, in this case, if it is still in the early stages of pregnancy, it is generally recommended to terminate the pregnancy and receive treatment first, and then consider pregnancy after the uterine cavity returns to normal. However, if it is already the middle or late stage of pregnancy and no symptoms occur during pregnancy, you can first undergo tocolytic treatment and closely monitor the condition, paying attention to changes in the tumor and observing whether there will be malposition of the fetus, threatened abortion, etc.