Treatment of uterine fibroid degeneration during pregnancy

A woman's body functions will also change during pregnancy, so expectant mothers with uterine fibroids must be careful. Uterine fibroids are very likely to degenerate at this time. Therefore, patients with uterine fibroids during pregnancy must observe their body changes at any time to prevent accidents. So, what should we do if uterine fibroids degenerate during pregnancy? Let’s see what the experts at the gynecological hospital say.

During pregnancy, due to the rich blood supply to the uterus, the fibroid tissue becomes congested, edematous, and the muscle cells hypertrophy, resulting in rapid growth of the uterus, especially in the first four months of pregnancy. After delivery, most fibroids can shrink. However, some patients may experience adverse changes such as hyaline degeneration, cystic degeneration and red degeneration due to changes in the environment around the fibroids during pregnancy, delivery and postpartum.

Among them, red degeneration of uterine fibroids is more common and has the greatest clinical significance. Red degeneration often occurs in uterine fibroids with a diameter greater than 6 cm and is common in the second and third trimesters of pregnancy. It is generally believed that red degeneration is due to the rapid growth of uterine fibroids, which obstructs blood circulation in the muscles, causing congestion and edema of the fibroids, and then ischemia and infarction, causing changes in blood test formation and hemolysis. Patients may experience symptoms and signs such as fever, abdominal pain, vomiting, local tenderness, and leukocytosis.

In addition, pedunculated subserosal fibroids may experience chronic or acute pedicle torsion, resulting in necrosis, infection, suppuration, and acute abdomen.

Submucosal fibroids may be caused by trauma due to surgery or compression by the fetal head, or they may become infected after the fibroids are prolapsed from the uterine cavity along with the fetus and placenta.

If uterine fibroids undergo red degeneration, whether during pregnancy or the postpartum period, conservative treatment, which mainly includes preventing infection, inhibiting uterine contractions and preserving the fetus, and symptomatic treatment without surgery, can almost always relieve the symptoms. If the subserosal fibroid is twisted and conservative treatment is ineffective, laparoscopic myomectomy can be performed. If the fibroids are embedded in the pelvic cavity and affect the continuation of pregnancy, or if the fibroids compress nearby organs and cause serious symptoms, surgical treatment should be required. The surgery generally requires the doctor to have skilled surgical techniques, gentle operation, and pay attention to preserving the fetus after the operation.