Do uterine fibroids affect pregnancy?

Uterine fibroids are a common disease among many women. After suffering from this disease, many women will feel worried. In fact, this is a benign tumor and generally will not cause great harm to women's bodies. So don't worry too much and just follow the doctor's advice for treatment. However, women may be afraid that uterine fibroids will affect pregnancy. So do uterine fibroids have any impact on pregnancy?

Uterine fibroids, also known as uterine leiomyoma, are the most common benign tumor of the female reproductive system. Most of them are asymptomatic, and a few may present with vaginal bleeding, abdominal masses, and compression symptoms. If pedicle torsion or other situations occur, it may cause pain, which is common in multiple uterine fibroids. The incidence of infertility in patients with uterine fibroids is approximately 22%-32%. It is a good thing if they can become pregnant. However, in early pregnancy, the incidence of miscarriage due to fibroids is 20%-30%. Since the tumor space affects the normal movement of the fetus in the uterine cavity, the incidence of abnormal fetal position is high, with the incidence of breech presentation as high as 24%, transverse presentation at 13%, or the presenting part not entering the pelvis. Fibroids affect the normal attachment and development of the placenta, leading to more frequent placenta previa or placental abruption.

The presence of uterine fibroids after delivery can cause uterine contraction dysfunction, making primary or secondary uterine atony more likely to occur, leading to prolonged labor or even dystocia. Fibroids can affect the normal separation of the placenta and increase the rate of placental retention. As the pregnant uterus grows, uterine fibroids also grow significantly, degenerating or compressing adjacent organs. The unique degeneration of fibroids during pregnancy is red degeneration, and subserosal fibroids are prone to pedicle torsion. The treatment of uterine fibroids combined with pregnancy requires rigorous treatment. The incidence of infertility is high, miscarriage after pregnancy accounts for a certain proportion, and there are many complications during pregnancy. Pregnancy care is particularly important. The treatment of complications requires appropriateness, and careful observation after delivery is required, whether it is a normal birth or a cesarean section, to prevent bleeding. If there is a bleeding trend, timely treatment should be given to prevent accidents.

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Uterine fibroids do not increase the risk of premature birth

Among women of childbearing age, about 1 in 5 has uterine fibroids, but the vast majority of women only discover they have uterine fibroids during their first prenatal check-up in early pregnancy.

Although the chance of developing uterine fibroids during pregnancy is not small, serious complications are rare (less than 1%). Uterine fibroids will change as pregnancy progresses. Some fibroids will change position, some will increase in size, and some fibroids will cause "reddening and degeneration" due to tissue congestion and thrombosis after pregnancy, leading to abdominal pain and uterine contractions. However, clinical observations and most statistical evidence have shown that uterine fibroids do not increase the risk of premature birth.

The fetus may be in an abnormal position, increasing the chance of caesarean section. There are very few serious complications that need attention!

However, it should be noted that some larger fibroids affect the rotation of the fetus, resulting in malposition of the fetus; some low-positioned fibroids block the fetal passage, increasing the chance of cesarean section. Only in very rare cases, such as when a pedicled serosal fibroid undergoes torsional necrosis, immediate surgery is required; or when a mucosal fibroid causes prenatal bleeding or placental abruption; or when a fibroid affects postpartum uterine contraction, leading to massive postpartum hemorrhage. Obstetricians and gynecologists must pay attention to these serious complications!

Most pregnant women with uterine fibroids can give birth smoothly

However, the author still wants to emphasize that the chance of serious complications is very low, so most of the time, uterine fibroids will accompany the pregnant woman until delivery and will not have a major impact. If a woman has experienced serious complications during pregnancy, such as premature birth, obstructed labor, or postpartum hemorrhage, she may consider myomectomy before her next pregnancy.

It is not suitable to remove uterine fibroids at the time of delivery!

As for some expectant mothers who think that they can deal with uterine fibroids during cesarean section, this is a very dangerous idea! Because the uterus becomes congested and enlarged during pregnancy, the peripheral blood flow increases greatly, which is not suitable for dealing with uterine fibroids; and removing uterine fibroids during cesarean section can easily cause complications such as heavy bleeding and poor uterine contraction, so general obstetricians and gynecologists will not make such recommendations.

[1] Fibroids growing in the lumen of the fallopian tube can cause the fallopian tube that benefits from its surface to stretch and twist, squeezing the lumen and affecting its patency, or cause the ovary to displace, widening the distance between the ovary and the fallopian tube, and hindering the egg-collecting function of the fimbria of the fallopian tube.

【2】Uterine fibroids can cause the frequency, amplitude and duration of uterine contractions to be higher than the normal baseline, interfering with the implantation of the fertilized egg or causing miscarriage after implantation. When fibroids are accompanied by uterine periosteal hyperplasia, it means that the ovaries do not ovulate. The fibroids cause uterine bleeding, infection, and blockage of the fallopian tubes, all of which can cause infertility.

【3】Larger uterine fibroids can deform the uterine cavity, which is not conducive to the passage of sperm, implantation of the fertilized egg and fetal development.

【4】Uterine fibroids growing in the cervix can compress the cervical canal. Blocking the channel or changing the direction of the cervical opening, moving it away from the semen pool in the posterior fornix, is not conducive to the entry of sperm into the cervical opening.

【5】Submucosal uterine fibroids that grow in the uterine cavity are like a spherical intrauterine device placed in the uterine cavity, hindering fertility. The endometrium on the surface of the uterine cavity is ischemic, necrotic, and atrophic, which is not conducive to the implantation of the fertilized egg.

【6】Myomas growing near the uterine horns can compress the opening of the fallopian tubes and cause blockage.