Can I get pregnant with uterine fibroids?

It is well known that the vast majority of patients with uterine fibroids will not become pregnant. It is generally recommended to choose pregnancy and childbirth only after uterine fibroids have been completely cured. Of course, this is not absolute. So for patients with uterine fibroids, if they want to get pregnant and have children, it is best for mothers to consult a doctor whether they are suitable for pregnancy. Only in this way can they welcome the little life in the healthiest posture.

Pregnancy after 1 year of uterine fibroid treatment

For women who wish 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 affecting conception, the doctor will recommend surgery or drug treatment to remove the fibroids or reduce their size. However, after treatment, most women will need to use contraception for one year before they can become pregnant.

Interaction between uterine fibroids and pregnancy

If you are already pregnant and then find out that you have uterine fibroids, how should you deal with them? Can you continue the pregnancy? If you continue the pregnancy, will it affect the embryo in the uterus?

Before answering these questions, let's first look at the relationship between pregnancy and uterine fibroids. In fact, pregnancy and uterine fibroids influence 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, endometrial lesions, and obstruction of the cervical canal. 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.; as the fibroids continue to grow and compress the uterus, it may also hinder the growth and development of the fetus, leading to malposition of the fetus, low placenta or anterior placenta, etc.; during delivery, if the fibroids obstruct, it may also prolong the delivery process due to reduced uterine contraction; in addition, after delivery, fibroids can lead to easy placental adhesion, difficulty in placental expulsion, and weak uterine contraction, 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. Red degeneration is the main degeneration during pregnancy. As the fibroids rapidly grow and become congested, patients may experience abdominal pain, accompanied by fever, which can lead to adverse consequences such as intrauterine fetal death, miscarriage, and premature birth.

Whether to terminate the pregnancy depends on the situation

As can be seen from the above, uterine fibroids have a bad effect on pregnancy. Does that mean that if fibroids are found during pregnancy, the pregnancy must be terminated? No, whether the pregnancy needs to be terminated depends on the size, location, month of pregnancy and the specific situation of the patient:

If it is a subserosal fibroid, that is, a fibroid that grows outside the uterus, the impact of this type of fibroid on pregnancy is relatively small, and the pregnancy can usually continue. However, if the subserosal fibroid has pedicle torsion and conservative treatment is no longer effective, surgical intervention is required.

As for intramural fibroids and submucosal fibroids, the former is a tumor that grows within the myometrium and is the most common type of uterine fibroids. The latter is a fibroid that grows in the uterine cavity and has the greatest impact on pregnancy among all types of uterine fibroids. However, submucosal fibroids affect the morphology of the uterine cavity and most of them will cause infertility or early miscarriage. The impact of intramural uterine fibroids on pregnancy varies depending on the size of the tumor. If the tumor is relatively small (less than 5 cm), 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.

If red degeneration of the fibroids unfortunately occurs during pregnancy, conservative treatment such as anti-inflammatory and fluid replacement can be used, which can usually relieve the symptoms. Most pregnancies complicated by uterine fibroids are able to give birth naturally, but care must be taken to prevent postpartum hemorrhage during delivery. If cesarean section is required to terminate the pregnancy due to fibroids hindering the descent of the fetus or other obstetric factors, whether the uterine fibroids are removed at the same time during the operation also needs to be determined according to the size, location and patient condition of the fibroids. The principle is that fibroids that are easy to remove and will not cause excessive bleeding can be removed during the operation, otherwise they can be observed and treated after delivery.

In short, when pregnancy is complicated by uterine fibroids, it is best to find a professional doctor to first evaluate the impact of the fibroids on the pregnancy. Pay attention to monitoring during pregnancy so as to keep abreast of the growth of the fetus and uterine fibroids, and take timely and effective measures to ensure the safety of mother and child.