Fibroids and pregnancy

Most of the time, fibroids don’t cause problems in pregnancy. But, depending on their size and location, they can occasionally lead to certain complications. When this happens, treatment varies depending on the specifics of each woman’s condition.

It’s believed that about 10-30% of women with fibroids will experience complications due to them during pregnancy. The most common effect is abdominal pain, which while possibly painful, doesn’t on its own present any risk. Other possible complications exist however, some of which are more likely to happen either earlier or later in pregnancy.

Fibroids during early pregnancy

In early pregnancy, there are two particular complications that fibroids may infrequently cause.

  • Bleeding: if the fibroids are located close to the placenta, bleeding is more likely in early pregnancy. It’s a good idea to speak to your healthcare provider about all bleeding during pregnancy, even if you are pretty sure that the bleeding is a result of a fibroid.
  • Miscarriage: most women with fibroids have no complications in pregnancy. But in the early stages of pregnancy, certain types of fibroids in specific locations can cause spontaneous pregnancy loss. Fibroids in the body of the uterus, in the uterine lining, or  that are growing in a stem-like shape, are more likely to cause miscarriage.

Fibroids during late pregnancy

Other complications can arise later in pregnancy.

  • Preterm labor: having fibroids increases a woman’s risk of going into preterm labor. This happens more when there are multiple fibroids, or when the fibroids are close to the placenta.
  • Placental abruption: placental abruption, when the placenta breaks away from the uterine wall, is likely to be more of a risk in a pregnancy where the woman has fibroids.
  • Placenta previa: some studies suggest that fibroids double the risk of placenta previa, a condition where the placenta blocks the opening of the uterus.
  • Fetal growth irregularities: studies seem to show that most fibroids don’t interfere with fetal growth, but in some rare cases, doctors noted growth abnormalities in babies whose mothers had significantly large fibroids.

Managing fibroids during pregnancy

It’s extremely rare for a provider to remove uterine fibroids while a woman is pregnant. This said, however, existing uterine fibroids occasionally grow in the first trimester, which can increase the chances that they’ll cause a woman pain. If this is the case, a woman’s provider will work with her to determine the best way she can manage this pain, most likely through nonsteroidal anti-inflammatory drugs. It’s only in very rare cases that surgery is used to remove painful fibroids.

Pregnancy and fibroids: what to know

It’s uncommon for uterine fibroids to cause complications for women who are pregnant. Medication and surgery are two of the most effective ways of treating fibroids, but each should be done in very specific circumstances so as to ensure the best health for a mother and her baby.

  • Hee Joong Lee, Errol R Norwitz, and Julia Shaw. “Contemporary Management of Fibroids in Pregnancy.” Reviews in Obstetrics and Gynecology. 3(1)20-27. Web. 2010.
  • “Uterine fibroids fact sheet.” Womenshealth. Office on Women’s Health, US Department of Health and Human Services, Jan 15 2015. Web.
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