Doctors at Peking Union Medical College say: Uterine fibroids are a high risk, pregnant mothers should not take it lightly

Last Wednesday's "Xiehe Doctors Say" tells the story of a 40-year-old elderly pregnant woman named Xiao A who has uterine fibroids. I believe everyone knows that pregnant women with uterine fibroids have many risks, so how to prevent them? Don't worry, today, Peking Union Medical College Hospital obstetrics experts will continue to answer your questions.

About the author: Ma Liangkun

Chief physician of obstetrics department of Peking Union Medical College Hospital, specializes in perinatal care, obstetric complications and comorbidities, prenatal diagnosis and genetic counseling.

What discomforts may pregnancy and uterine fibroids cause?

First of all, pregnant mothers need to understand the various discomforts that pregnancy and uterine fibroids may cause . Pregnant mothers may experience lower abdominal discomfort due to uterine growth, round ligament pain, pelvic girdle pain and uterine sensitivity due to insufficient core muscle strength, uterine contractions during threatened abortion or threatened premature birth, and local pain caused by degeneration of uterine fibroids.

Pain caused by round ligament pull is a normal manifestation of the body adapting to pregnancy . When the body position changes suddenly, such as from sitting to standing, the pelvis twists excessively, or laughing or coughing increases abdominal pressure, the round ligament may be pulled by external force, causing pain. This pain often occurs in the lower abdomen (one side or both sides), hip joints, and groin (the oblique depression at the base of the thigh). The pain is mostly sharp, strong and short-lasting (usually lasting a few minutes), which is the "throbbing pain" described by pregnant mothers.

The core muscles are the middle link of the human body, responsible for stabilizing the center of gravity and transmitting strength, and are the body's "energy source". Women who sit in the office for a long time and lack exercise will have insufficient abdominal muscles, weak gluteus maximus and gluteus medius, and tight erector spinae, quadratus lumborum, latissimus dorsi and iliopsoas. Such uncoordinated muscles will cause the pelvis to tilt forward and "lower cross syndrome" will occur, which is the main cause of low back pain.

During pregnancy, the uterus rapidly enlarges and the abdomen gradually bulges, gradually stretching the bilateral rectus abdominis, internal oblique muscles, and external oblique muscles to their limits. The contraction ability and elasticity of the abdominal muscles are significantly reduced. Coupled with the incorrect posture of pregnant mothers, the secretion of relaxin, and the lack of core muscle strength, it will lead to back pain, abdominal wall tension, uterine sensitivity, and bladder pressure. Some pregnant mothers will experience uterine contractions after the bladder is full (holding urine) or walking due to uterine sensitivity.

The uterine contractions that occur during threatened abortion or threatened premature birth are similar to the discomfort, soreness, cramps, and pulling pain in the lower abdomen during menstruation. They may last for more than ten seconds and usually do not exceed one minute. Pregnant mothers should learn to observe the degree, duration, interval time and possible triggering factors of the pain.

Pregnant mother Xiao C, who experienced uterine contractions in the second trimester, recorded her own feelings and status, and actively communicated with the doctor. She found that the feeling of uterine contractions was related to posture, flatulence, urination, constipation, etc. The pain score ranged from 1 to 3 points, which was related to the sensitivity of the uterus caused by insufficient core muscle strength. Through self-observation, relaxation and decompression, symptom recording and analysis, and regular prenatal examinations and monitoring, Xiao C finally gave birth to a full-term baby, and we also received a warm thank-you letter:

Thank you letter

"Hello, Dr. Ma. I am here to share the good news. I gave birth to a 7-pound baby girl last night. Although the process was a bit difficult, the baby is healthy and cute and I am very satisfied! Thank you very much for your guidance. It has helped me understand the importance of diet and exercise during pregnancy. The concept of healthy diet and reasonable exercise has been deeply rooted in my heart. I believe it will have a positive impact on my future life. I also want to thank you for giving me confidence in preserving the fetus. The baby was born at 39+ weeks. Thank you again sincerely, and I wish you a happy life and work in the future."

Finally, there is local pain caused by the degeneration of uterine fibroids . The red degeneration of uterine fibroids is manifested by rapid enlargement of the fibroids, abdominal pain, fever and elevated blood counts. This pain is usually obvious locally in the uterine fibroids, with tenderness and rebound pain, accompanied by fever, symptoms of infection, and may also be accompanied by pain and discomfort from uterine contractions.

What should pregnant mothers do?

Let's go back to Xiao A mentioned at the beginning. She came to the clinic for a routine prenatal checkup at 13 weeks of pregnancy. The examination found that Xiao A's uterine fundus was located one finger below the navel. The Doppler stethoscope detected the fetal heart rate, and Xiao A's eyes were filled with tears of excitement. She recorded the baby's fetal heart rate as a souvenir. Then we told Xiao A the location of the uterus and fibroids, the possible feeling of uterine growth, and the pain characteristics of round ligament pulling pain, uterine contraction and fibroid degeneration.

Under our guidance, Xiao A understood that she should learn to observe pain and discomfort. If the pain is frequent and persistent, accompanied by severe abdominal pain, bleeding, colic, fever, chills, nausea, vomiting, or abnormal changes in vaginal discharge, she should go to the hospital for emergency treatment in time to identify the cause and treat the symptoms. At the same time, Xiao A also understood that she should learn not to magnify the feeling of discomfort and not to be overly nervous and anxious, which leads to frequent medical treatment.

Psychological counseling during pregnancy can help pregnant mothers adjust their emotions and maintain a peaceful state of mind. Nutritional management can help prevent anemia, macrosomia, or small-for-gestational-age infants. A healthy lifestyle, including preventing colds, diarrhea, vaginal inflammation, and eating less inflammatory foods such as barbecue and fried foods, can prevent premature births caused by various infections and inflammatory conditions.

Xiao A's body composition shows that her muscles are not strong enough, so it is particularly important to strengthen her core muscles . Otherwise, as the uterus continues to grow, she will have a sagging abdomen, loose belly and sagging outward, further aggravating her discomfort. Therefore, it is necessary to maintain a healthy body shape , perform reasonable and effective exercises under the guidance of a coach, and observe the symptoms of discomfort .

To sum up: advanced age, test-tube babies, various disease conditions, etc. are not things we can change in a short period of time, or even cannot be changed . We can only accept them calmly and do the best we can within our capabilities.

Every pregnant mother's pregnancy process is a unique experience, and every little fragment of this experience may have some impact on the baby's growth and development and future growth. We hope that every pregnant mother can harvest the most intimate memories with her baby during this precious pregnancy process, and use this pregnancy to completely improve her or even her family's diet and exercise habits, reduce the incidence of diseases related to unhealthy lifestyles, harvest healthy babies and restore a healthy and firm body! I hope all pregnant mothers can be optimistic, enthusiastic, love life, and love themselves!

Content from: Ma Liangkun, a doctor at Union Medical College Hospital