How to Deal with Fibroids During Pregnancy and What You Should Know?

Pregnancy is always a great feeling for any woman and couple all together. But the shadow of fibroids raises lots of concern, making them overthink whether their baby will be safe. How to deal with fibroids during pregnancy, and will it lead to miscarriage risk? 

Fibroids’ complications in pregnancy depend on how big they are and where they are during pregnancy. Fibroids are non-cancerous tumours that are present, which may lead to complications during pregnancy. Fibroids form when the hormone estrogen increases during pregnancy.

For some women, fibroid tumours go down (reduce) during pregnancy. This article will help you know everything about fibroids, their symptoms, how they come about, and the promising methods of treating fibroids.

What Are Fibroids?

Fibroids are non-cancerous growths that develop in or around the womb (uterus)

Fibroids exist in different sizes, ranging from tiny undetectable seedlings to large masses that modify the uterus’ structure and dimensions. Women can have one or multiple fibroid cysts present in their bodies.

The occurrence of fibroids remains high throughout the female population. The prevalence of uterine fibroids in women between childbearing ages reaches 20-40% and continues to affect 80% of women at the age of 50.

Doctors believe hormonal body changes and genetic alterations contribute to fibroid development. What causes fibroids during pregnancy?  Although no particular cause exists. The risk of developing fibroids becomes greater when a person has blood relatives who suffer from this condition. 

More to read : How to Shrink Fibroids

What are the symptoms of pregnancy with fibroids?

Fibroids often go unnoticed, as they do not always produce signs or symptoms.

Your symptoms will differ based on the number of fibroids you have and their size and position in your body. Below is the answer to what are the symptoms of pregnancy with fibroids: 

Women, especially those who are pregnant, may experience symptoms such as:

1. Severe back pain
2. Feeling of fullness, pain, or pressure in the lower abdomen
3. Painful cramps, similar to period cramps
4. More frequent or uncomfortable urination
5. Pain during sex
6. Constipation or painful bowel movements, especially if the fibroids exert a lot of pressure on that area

Things To Expect When You Are Prone To Fibroids During Pregnancy

The question, however, might arise: “Can you become pregnant with fibroids? Can it harm my baby, etc? Here’s what to expect and fibroids during pregnancy complications.

First Trimester

Uterine fibroids have a higher chance to grow in a woman’s first trimester during pregnancy. Without estrogen, a female reproductive hormone, they cannot grow and develop fibroids. There is more estrogen in a woman’s body when pregnant.

These are some issues pregnant women who have uterine fibroids may encounter:

• Pain and Bleeding: A study analyzing over 5,000 female patients found that 11 per cent of patients reported bleeding, and 59 per cent reported pain only. Additionally, 30 per cent of pregnant women experienced both pain and bleeding.
• Miscarriage: Women with fibroids are at risk of miscarrying at an early stage of pregnancy. The statistics also say that women with fibroids are more likely to have miscarriages (14% vs 7.6%). The risk is increased even higher if the patient has a fibroid pregnancy with multiple or large growths.

Second and Third Trimesters

Pregnancy fibroids are life-threatening for the child, and the risk increases with the pregnancy. A patient’s uterus typically expands during the second and third trimester to accommodate a growing baby. The result is that the uterus can push upon growth. 

Fibroids can sometimes cause pregnancy loss

• preterm labor
• premature rupture of fetal membranes (PROM), leading to the water breaking early
• hemorrhage soon before delivery
• malpresentation, where the fetus is not in the right position
• obstructed labor
• hemorrhage following delivery
• Necrosis disrupting the blood supply or causing cell death

Delivering baby

Is it possible to get pregnant with fibroids? It’s possible. However, fibroids can complicate delivery. Experts say these growths can increase your chances of having a c-section. The likelihood of a woman having a C-section is six times higher for women with uterine growth.

Fibroids Post-Delivery

Fibroid pregnant women can see their growths shrink after giving birth. Women who give birth live have a 70% chance of shrinking their uterine fibroid.

Treatment Of Fibroids Before Pregnancy

Treatment for uterine fibroids can vary depending on the size, number and location of the fibroids, as well as what symptoms they’re causing. If you aren’t experiencing any symptoms from your fibroids, you may not need treatment. Small fibroids can often be left alone. Some people never experience any symptoms or have any problems associated with fibroids. In these cases, your provider may recommend monitoring your fibroids with pelvic exams or ultrasounds.

If you’re experiencing symptoms from your fibroids — including anemia from excess bleeding, moderate to severe pain or urinary tract and bowel problems — you’ll need treatment to help. The best treatment option for you will also depend on your plans for pregnancy in the future. Talk to your doctor about your fertility goals when discussing treatment options. Treatment options for uterine fibroids can include:

Medications

• Over-the-counter (OTC) pain medications: These medications help manage pain and discomfort caused by fibroids. 
• Iron supplements: If you have anemia from excess bleeding, your provider may also suggest you take an iron supplement.
• Birth control: Birth control can also help with symptoms of fibroids — specifically, heavy bleeding during and between periods and menstrual cramps. There are a variety of birth control options you can use, including oral contraceptive pills, rings, injections and intrauterine devices (IUDs).
• Gonadotropin-releasing hormone (GnRH) agonists: These medications work by shrinking fibroids. They’re sometimes used to shrink a fibroid before surgery, making it easier to remove the fibroid. However, these medications are temporary, and if you stop taking them, the fibroids can grow back.
• Oral therapies: Elagolix is a new oral therapy to manage heavy uterine bleeding in people who haven’t experienced menopause with symptomatic uterine fibroids. It can be taken for up to 24 months. Talk to your doctor about the pros and cons of this therapy. Another oral therapy, tranexamic acid, treats heavy menstrual bleeding in people with uterine fibroids.

There are several factors to consider when talking about the different types of surgery for fibroid removal. 

Myomectomy is a procedure that allows your provider to remove the fibroids.

If you aren’t planning future pregnancies, there are additional options your healthcare provider may recommend. These options can be very effective, but they typically prevent future pregnancies. These can include:

• Hysterectomy: Your provider removes your uterus during a hysterectomy. 

Uterine fibroid embolization: An interventional radiologist performs this procedure with the help of your gynecologist. They put a small catheter in your uterine artery or radial artery and inject small particles, which then block the flow of blood from the artery to the fibroids. Loss of blood flow shrinks the fibroids and improves your symptoms.

• Radiofrequency ablation (RFA): This is a safe and effective treatment that uses microwave (RF) energy to treat uterine fibroids. It’s recommended for people who haven’t reached menopause. It treats smaller fibroids.

Women who have fibroids before pregnancy can consider multiple treatment choices for their condition. Consult your doctor about the most suitable treatment option since various options present risks and complications.

When To See A Doctor?

Most fibroids do not create medical threats to the patient. If you feel that fibroids are present, it’s best to visit a doctor whenever you want to get pregnant. 

The doctor needs all the information to check embryonic development effects and treat uncomfortable symptoms during pregnancy. 

Conclusion

Uterine fibroids are identified as a potential factor that might impact your ability to get pregnant. Uterine fibroids have the potential to create negative effects throughout the entire pregnancy period. These tumours rarely trigger pregnancy complications or fertility problems.

Speak with your doctor about available treatment options because getting pregnant with fibroids creates certain risks. You and your partner should choose the most secure options during pregnancy.

References: 

HealthLine – https://www.healthline.com/health/womens-health/fibroids-pregnancy

National Institutes of Health – https://pmc.ncbi.nlm.nih.gov/articles/PMC2876319/