Complications And Management Of Fibroids In Pregnant Women

In some women, uterine fibroids do not always cause obvious symptoms, meaning they can be asymptomatic at times. Consequently, the first time a pregnant woman may discover she has fibroids is when she goes for her first routine prenatal scan.

Fortunately, most fibroids are harmless and cause few complications during pregnancy. Some women diagnosed with fibroids before becoming pregnant may worry that pregnancy will cause the fibroid(s) to grow more rapidly; particularly as excess estrogen hormones are a known risk factor. Recent research indicates that most fibroids (80 percent) do not actually increase in size during pregnancy and those that do, shrink back to their pre-pregnancy size again after childbirth. If a fibroid is going to grow, it is likely to do so in the first trimester of pregnancy.

It is estimated that one in every 1,000 pregnant women has fibroids, although this figure may be underestimated. Fibroids are more likely to occur in women experiencing a pregnancy after 35 and those who underwent infertility treatment. It is estimated in both categories that the incidence rate could be as high as between 12 to 25 percent.

Common Complications

Common fibroid Complications

Abdominal Pain

Many women with fibroids notice increased abdominal pain when they become pregnant. This is due to a condition technically known as red degeneration of fibroids. It is caused by the hemorrhage of blood into the tumor which starves the surrounding tissues. It affects about 10 percent of all women with fibroids during pregnancy. Most commonly it occurs in the last trimester or when fibroids are over 5cm in size.

Symptoms may appear similar to those of a twisted ovarian tumor or acute appendicitis. That is: sudden pain, a general feeling of unwellness and fever. The tongue may be dry and the pulse races. Constipation and tenderness in the area of the abdomen where the fibroid is located are also signs.

Although, the pain is unpleasant, it is not usually anything to worry about. Do always report any pain or bleeding to your pregnancy healthcare team. Bed rest for 3 or 4 days in addition to safe pain relievers (analgesics) is usually prescribed.

Abdominal Pressure

As the baby grows and space is restricted in mother’s body, fibroids may cause an uncomfortable pressure as they squeeze on nearby organs. A sharp pain in the legs and lower back may occur if nerves become restricted and compressed.

Type, Size and Location

Receiving an accurate fibroids diagnosis is important as this will provide information on the type of fibroid growth, its size, how many there are, and where they are located. One study carried out in 1993 investigated 12,500 pregnant women with fibroids and discovered in the vast majority of cases (88 percent), only one fibroid was present. They reported an increased risk of pain and bleeding during pregnancy in women with large fibroids measuring 200cm cube volumes or more, or when the fibroid was located underneath the placenta.

For this reason, knowing as much as possible about the type(s) of fibroid present will help a physician predict how it is likely to react during pregnancy.

For example, submucosal fibroids, the least common type, can grow through the lining of the uterus and make the cavity inside the womb too small for the baby to grow in over 9 months. In fact nearly 40 percent of pregnancies with submucosal fibroids end up in miscarriage (often before the woman even knows she is expecting).

Subserosal fibroids project out of the uterus wall and can grow quite large. Although they do not affect space inside the womb, they are more likely to result in abdominal pain or pressure.

Pedunculated fibroids are attached to the uterus by thin stalks, they do not tend to cause problems in pregnancy although if the stalks twist (fibroid torsion), they can cause a severe sharp pain.

Less Common Complications

Miscarriage

The chance of spontaneous miscarriage is greater in women with fibroids. Research indicates that multiple fibroids increase the chance by nearly 24 percent compared to a single fibroid at 8 percent. The location of the fibroid is important as submucosal fibroids for example can increase the rate of miscarriage significantly. Why fibroids should increase the chance of miscarriage is not clear but it may be because the tumors increase irritation of the uterine or they have a compressive (squeezing) effect on the womb or they may reduce blood supply to the developing placenta and fetus.

Bleeding In Early Pregnancy

The location of the fibroid tends to be the most important factor here. The closer the ... See more at: http://www.planbwellness.com/fibroids-pregnancy/#sthash.2bTDnea8.dpuf