Having anything that complicates your pregnancy is scary. Fibroids, however, don’t have to be one of them. Many women who have fibroids in pregnancy have no trouble, and they deliver perfectly normal babies. However, being pregnant with fibroids does put you at risk for potential complications – including pain, bleeding, placental problems, preterm labor, and problems during childbirth. Because of the risk for pregnancy complications, your doctor will monitor your pregnancy closely and offer a treatment plan based on the size and location of your fibroids.
Try not to worry, though. Fibroids often don’t interfere with your pregnancy. You may not even need any treatment for them. Even with fibroids, you still have a good chance of having a healthy baby.
What are Fibroids?
Fibroids are non-cancerous (benign), muscular tumors that grow in or around the uterus. They are very rarely cancerous. A cancerous fibroid (which is called leiomyosarcoma) only occurs in less than 1 in 1,000 cases. Having a fibroid doesn’t increase your risk of developing leiomyosarcoma, and it doesn’t increase your risk of getting other uterine cancers.
You can have one fibroid, or many fibroids in your womb. They can range in size – from the size of a rice grain to the size of a grapefruit or even larger. In non-pregnant women, they can cause you to have very heavy menstrual bleeding or long menstrual periods. Any woman with fibroids – pregnant or not – can have pelvic pressure or pain.
Other names for fibroids include leiomyoma, myoma, and fibromyoma. It is a very common reproductive problem that can affect women. It is estimated that between 20 to 80 percent of all women will develop fibroids by age 50. The exact cause of fibroids isn’t known, but it’s speculated that estrogen playa a role. After menopause, when your body is no longer producing estrogen, these unwelcome, benign tumors shrink away and disappear.
Types of Fibroids
Because fibroids can grow in a number of locations, doctors have separated them into three specific groups, based on their location.
- Submucosal fibroids are located in your uterine cavity (which is where your pregnancy grows). This is the least common type of fibroid, but it can cause you to have prolonged and heavy menstrual periods.
- Intramural fibroids are found within your uterine wall. When they expand, they can make your uterus feel bigger than normal. If you have this type of fibroid, you can have pelvic pain and pressure, heavy menstrual bleeding (when you’re not pregnant), frequent urination, and back pain.
- Subserosal fibroids are located on the outer part of your uterus and grow outward. They often don’t affect your menstrual flow, but they can cause pain and discomfort.
- Pedunculated fibroids are found on stalks that grow out from the surface of your womb, or into your uterine cavity.
Fibroids and Pregnancy
For the most part, if you have fibroids and you’re pregnant, you really shouldn’t worry too much. There’s a good chance that you will deliver a healthy baby, and that your pregnancy will be uncomplicated. However, there is a chance that your pregnancy hormones – which help your uterus grow to accommodate the increasing size of your baby – may also help a pre-existing fibroid get even larger. For this reason, regular prenatal care is crucial when you have a fibroid during pregnancy.
Fibroids are more likely to grow in the first trimester, when estrogen and other hormones are increasing dramatically to help support your pregnancy. This increase in estrogen can cause pre-existing fibroids to increase ten times in size (or more). A large fibroid can potentially cause you severe pain and other problems. Some women may need hospitalization with a large fibroid. Although many pregnant women don’t require treatment for their fibroids, sometimes you may need surgery to remove a large fibroid to prevent complications.
Having fibroids is often not a dangerous complication, though. With today’s medical advances, including the use of ultrasounds, your baby and fibroids can be monitored. Ultrasounds are very helpful in keeping track of the size and location of the fibroids.
Pregnancy Complications with Fibroids
Although the odds are in your favor when you have a fibroid during pregnancy, you do still need to be educated on the potential complications that may occur – including the need for a C-section due to a fibroid obstructing your birth canal, preterm contractions, early labor and delivery, placental problems, and other complications.
- Miscarriage is a potential problem when you have fibroids. Although miscarriage can occur in the healthiest women, if you have fibroids, it is possible for your fibroid – especially a submucosal fibroid, which grows in your uterine cavity – to get in the way of the growth of the placenta. This can lead to a first trimester miscarriage. There are also some studies that indicate that uterine fibroids may also increase your chance of a second trimester miscarriage, but your risk is fairly low.
- Placental problems can occur with a fibroid. Women with a large fibroid, or a fibroid that has grown into the area where your placenta is attached to the uterus, are more likely to experience placental abruption – a complication that occurs when the placenta separates (or detaches) from the uterus wall before your baby is full-term. Placental abruption can deprive your developing baby of its oxygen supply. Preterm delivery may be required to save your baby’s life.
- Complication during labor and delivery are another possible problem with fibroids. You may have a difficult time delivering vaginally if you have a fibroid that is located near the cervix. The location of this forbid can potentially block the opening of your womb (cervix) and make it difficult for you to dilate efficiently. It’s also possible that this fibroid can cause your labor to stop progressing. As a result, you may need to have a cesarean section.Sometimes a “misplaced” fibroid in your uterus can cause your baby to present differently – i.e. breech (head up, bottom down) or transverse (sideways across your abdomen), and this can force you to have a C-section.
A large fibroid can also increase your risk of postpartum hemorrhage (heavy bleeding after delivery). In addition, it’s also possible that a fibroid can block the afterbirth (placenta) from being delivered, and it can sometimes prevent your uterus from contracting after you’ve had your baby.
Although all of these complications do sound scary, don’t let them frighten you. Many women never experience them, though some do. Most doctors and healthcare providers opt for a “let’s wait and see” approach when it comes to fibroids in pregnancy. Your healthcare provider will guide you on the right treatment plan based on your specific pregnancy.
The bottom line is that fibroids in pregnancy are generally harmless, however, since you may face certain complication, it’s a good idea for you to have regular prenatal care with a midwife, OB/GYN, or other healthcare provider.
PLEASE NOTE: The information provided on this blog should not be construed as providing medical advice, but it offers general information about fibroids in pregnancy. Always contact your doctor or healthcare professional if you have questions about your own individual situation.