Fibroids are benign, non-cancerous tumors that grow in your uterus from muscle tissue. They can be larger than a grapefruit or as small as a pea. They can grow inside your uterine cavity, outside your uterine wall or within your uterine wall. Some women can even have multiple fibroids of various sizes. By the age of 35, up to an estimated 60 percent of women have fibroids, and up to 80 percent will develop them by age 50.
Pregnancy and fibroids raise many questions for women. Since uterine fibroids could pose numerous potential problems before, during and after pregnancy, women may ask, “Can I get pregnant with fibroids?” and “Should I have a baby with fibroids?” This article answers all your questions about pregnancy and uterine fibroids.
What Are the Symptoms of Fibroids in Pregnant Women?
Often, women learn they have uterine fibroids when they go to their first ultrasound appointment to monitor their baby’s development. This is because many women who are experiencing fibroid symptoms think they are normal and disregard them. Only when they become more severe, do most women who are pregnant notice a change and seek professional help.
Over 30 percent of women can experience fibroid symptoms during their pregnancy consisting of pain and bleeding. In one study, nearly 60 percent of women experience pain with their fibroids during their first trimester, while just over 10 percent experienced bleeding only.
Should I Conceive If I Have Fibroids?
Conceiving with fibroids isn’t usually a problem, and many women with fibroids will become pregnant naturally and don’t require treatment for conception. Sometimes, depending on where and how the fibroids are growing, conceiving with uterine fibroids becomes a challenge. Fibroids can impact your fertility and lead to pregnancy complications.
Is pregnancy with fibroids high risk? Most women with fibroids can go on to have a healthy pregnancy without any complications. Some, however, experience challenges.
For instance, if your fibroids grow on the inner wall of your uterus or in your uterine cavity, they could affect implantation and growth of the embryo, leading to infertility or miscarriage.
Also, if your fibroids are big enough that they distort your uterus structure, it can lead to reduced fertility success regardless of whether they’re growing in your uterine wall or into your uterine cavity. While specialists initially thought fibroids that grew out of the uterus didn’t affect fertility, recent research shows these fibroids could reduce IVF success.
So, if you received a uterine fibroid diagnosis, and you’ve been dealing with infertility, you could still become pregnant whether or not you have the fibroids removed surgically. Having surgery doesn’t guarantee you’ll experience improved fertility, but it’s an option you may want to discuss with your doctor. They can determine if your fibroids are playing a role in your infertility and determine the best route to take.
While fibroids can cause some women to experience infertility, doctors often find more common explanations for infertility. If you’re having issues with fertility or maintaining a pregnancy, your doctor might check for other potential causes before they decide the culprit is your fibroids.
Uterine fibroids can reduce fertility in various ways, including:
- Cervix shape changes can impact how many sperm enter your uterus.
- Uterus shape changes can interfere with the sperm’s or embryo’s movement.
- They can affect the size of your uterine cavity’s lining.
- They can block your fallopian tubes.
- They can affect the flow of blood to your uterine cavity, thus decreasing the embryo’s ability to implant in your uterine wall or to develop.
So, if you’re wondering if you can get pregnant with uterine fibroids, consult with your doctor to determine the location and size of your fibroids. Ask them if the fibroids could cause challenges with your attempts at conceiving or your ability to carry a pregnancy to term. You’ll also want to find out if treating the fibroids will improve your chances of becoming pregnant.
Will My Baby Be in Danger If I Have Fibroids?
If you have fibroids, you’re probably asking questions like, “Can you carry a baby with fibroids?” and “Will my baby be okay if I have fibroids?” Know that fibroids do not put your baby in danger. In fact, it’s rare for fibroids to affect a baby unless there’s substantial bleeding. Even if you’re experiencing symptoms, they won’t likely affect your baby. But, with fibroids, your risk of premature delivery or miscarriage does slightly increase.
Even though they’re rare, these are the pregnancy risks of having fibroids:
1. Growth Problems and Premature Delivery
While this doesn’t often happen, if you have multiple large fibroids, your uterus may fail to distend appropriately, and lead to growth problems with the fetus or your water can break early, putting you into premature labor. If your placenta implants on a fibroid, your pregnancy might lack nutrition and the ideal blood supply needed for your baby to grow properly.
Your doctor will measure your belly during your pregnancy to ensure your baby is growing as it should. If your fibroids are large, they could alter the measurements, making them less accurate, so you may require more frequent ultrasounds. A lot of women with fibroids, however, have healthy, growing babies and deliver at term.
In some cases, fibroids can misshape your uterine contour to the point where the baby can’t get head down, and therefore, you can’t have a vaginal delivery. In these situations, doctors tend to suggest a cesarean delivery (C-section) rather than attempting to turn the baby.
In other cases, the baby is head down, but the large fibroids block the cervix or lower uterine segment, so the baby’s head can’t dilate the cervix properly. This requires a C-section, but it’s rare. A C-section, though, is more common in women with fibroids. In serious cases, fibroids can lead to extremely preterm births, particularly if your fibroids become bigger rapidly after your pregnancy begins.
Despite the increased risk of requiring a C-section, a lot of women with fibroids can still have normal vaginal births without complications. Unless the location and size of your fibroids are blocking your cervix or affect your baby’s ability to move into the right position, you’ll likely have an uncomplicated vaginal birth.
As your uterus grows and the fibroids change in size, even if the fibroids seem to be a concern earlier in your pregnancy, they could become less of a concern as your doctor monitors your pregnancy.
If your doctor suggests a C-section early in your pregnancy, you may want to ask them to monitor the fibroid during the third trimester of your pregnancy so they can determine if a C-section is still the proper route to go. Your situation could change, and you may no longer require surgery.
What Are the Effects and Risks of Fibroids on Pregnancy?
Fibroids during pregnancy could pose some risks during all three trimesters, during delivery and postpartum.
Problems During Your First Trimester
In most cases, during pregnancy, the fibroids don’t grow, but if your fibroid does grow, it will likely do so during your first trimester — the first three months. This is because fibroids probably require estrogen to grow. When you’re pregnant, your body makes more estrogen.
The main issues that could occur are:
1. Pain and Bleeding
A study with over 4,500 women participants showed 11 percent of the women with fibroids experienced bleeding, and 59 percent only experienced pain. But, 30 percent experienced both during their first three months of pregnancy.
Women with fibroids have a higher risk for miscarriage during early pregnancy than those without fibroids (14 percent vs. 7.6 percent). Your risk could go even higher if you have multiple fibroids.
Second and Third Trimesters
To make room for the baby, your uterus expands, and it could push against your fibroid, causing numerous problems during your pregnancy.
Pain is one of the most common symptoms of fibroids, particularly when they’re big. In some cases, fibroids twist, causing discomfort and cramping. In other cases, they outgrow their blood supply, turn red and die. Known as “red degeneration,” this process can lead to severe stomach pain and sometimes even miscarriage. To relieve the pain, you can try taking acetaminophen (Tylenol) but refrain from taking ibuprofen (Motrin, Advil) during early pregnancy as well as during your third trimester since it could cause miscarriage.
2. Placental Abruption
When pregnant, you have a greater risk of placental abruption if you have fibroids. Placental abruption is where your placenta tears away from your uterus wall before you deliver your baby. It’s extremely serious since you could experience heavy bleeding, which could put you in shock, and your baby won’t get sufficient oxygen.
3. Placenta Previa
Placenta previa is when your placenta attaches over your cervix in your lower part of your uterus instead of the upper part. In some cases, it could be near your cervix opening which you call a low-lying placenta. Placenta previa occurs in one of 200 deliveries.
With placenta previa, you may experience painless, sometimes profuse bleeding late in your pregnancy. Your doctor can perform ultrasonography to confirm the diagnosis. You may only need modified activity, but if you or your fetus develop problems or the bleeding continues, you may require a cesarean delivery.
Up to 15 precent of women who are pregnant experience placenta previa during their second trimester. Placenta previa resolves on its own in over 90 percent of women before they give birth. If it doesn’t resolve on its own, the placenta can detach from your uterus and deprive your baby of blood supply.
You have a higher chance of developing placenta previa if you:
- Have been pregnant more than once
- Have had a C-section
- Have fibroids or another structural abnormality of your uterus
- Are pregnant with multiples
- Are older
4. Preterm Delivery
Giving birth with fibroids puts you at a higher risk of preterm delivery, which means you deliver your baby before your 37th week of pregnancy.
Fibroids could keep your uterus from contracting. They could also cause birth canal blockage, which slows down the progress of your labor.
Another potential problem is having a breech birth. During a normal delivery, your baby would come from the birth canal head first. Babies come out feet- or buttocks-first during a breech birth.
With fibroids, you’re at a higher risk for excessive bleeding regardless of whether you had a vaginal birth or C-section. Typically, this occurs when your placenta is attached to your uterus abnormally (placenta increta or acreta). You’re more likely to experience abnormal placentation if you’ve had a prior myomectomy or cesarean birth.
Your doctor might request you have a certain IV in place as well as ensure there’s blood available exclusively for you during delivery depending on your fibroid situation. Large obstetric units are well-equipped with vast postpartum hemorrhage protocols to ensure rare emergencies like these are quickly handled and that both the baby and the mother receive the best care possible.
What Are the Effects of Pregnancy on Fibroids?
Pregnancy can cause your fibroids to grow or shrink.
Usually, most fibroids keep the same size during pregnancy, but some grow. In fact, according to a 2010 review, in the first trimester, one-third of fibroids might grow. As mentioned earlier, estrogen possibly causes fibroid growth, and estrogen levels go up when you’re pregnant.
Still, your fibroids can also shrink when you’re pregnant. Researchers conducted a study in 2010 and found 79 percent of fibroids present before pregnancy shrunk in size following delivery.
How Are Fibroids Diagnosed
Fibroid diagnosis in pregnant women is neither straightforward nor simple. Doctors typically can diagnose only 42 percent of big fibroids and 12.5 percent of smaller fibroids on physical examination. Ultrasound has its limits when it comes to detecting fibroids during pregnancy with 1.4 to 2.7 percent diagnoses mainly because doctors have trouble distinguishing fibroids from the myometrium’s physiologic thickening.
The doctor, however, may find you have uterine fibroids during your routine pelvic exam. They might even feel the fibroids during your examination and estimate the size.
To confirm the diagnosis, they might order imaging tests, or they might suggest hysteroscopy or laparoscopy to look inside you using a scope. In hysteroscopy, the doctor inserts the scope in your vagina and cervix. With laparoscopy, they make a tiny incision close to your navel for scope insertion.
Speak to a Specialist
It’s natural for you to concern yourself about the well-being of your baby. The good news is pregnant women with fibroids have little to worry about. Still, it’s best to consult with a doctor about the potential effect your fibroids can have on your pregnancy. Schedule a consultation to talk to a professional or find a permanent solution to your fibroids.
At USA Fibroid Centers, we provide a national network of outpatient medical centers specializing in non-surgical uterine fibroid treatment. In each of our 30 centers around the U.S., we employ qualified and professional physicians. We’ve helped hundreds of people eliminate their fibroid symptoms so they can enjoy their lives using the minimally invasive and innovative Uterine Fibroid Embolization (UFE) treatment.