The Risks of Fibroids During Pregnancy

Almost one in three women over the age of 35 have fibroids that can be detected by examination or ultrasound. Fibroids are the most common tumors in the female genital organs. Although the tumor is dangerous in most people, the aforementioned fibroids are generally benign and harmless. We can say that they are small vesicles formed in the body.

Prof. Dr. Ulun ULUĞ
Written by Prof. Dr. Ulun ULUĞ. 0 comments 4832 views

What is myoma?

Most patients have more than one uterine fibroid, the number sometimes exceeding 50. Estrogen, known as the female hormone, causes fibroids to grow. For this reason, fibroids usually enlarge about 2-3 times in reproductive age and pregnancy, and in menopause, they usually shrink if the patient does not use hormone medication.

Fibroids also differ according to their location in the uterus. They can grow into the lining of the uterus, as well as in the muscle tissue of the uterus. In addition, fibroids and pedunculated fibroids that grow out of the uterus can also be seen in women. Apart from this, there may also be fibroids developing in the ovarian region.

Myomların riskleri

What are the types of fibroids?

Submucous Fibroids

They are fibroids that grow towards the inner surface of the uterus. It is the least common type of fibroid. However, the most bleeding problem occurs in this type of fibroids. Bleeding is usually seen with increased menstrual bleeding and prolonged menstruation.

Intramural Fibroids

They are fibroids located in the muscle tissue of the uterus. It is the most common type of fibroid. Like submucous fibroids, they cause an increase in menstrual bleeding, prolongation of the menstrual period and, accordingly, anemia. At the same time, it causes pain in the abdomen and a feeling of fullness as a result of enlargement in the uterus and frequent urination as a result of pressure on the urinary bladder.

Subserous Fibroids

They are fibroids that grow towards the outer surface of the uterus. They do not cause bleeding problems. It is mostly manifested by problems such as abdominal pain, back pain, feeling of fullness and frequent urination, constipation.

What are the symptoms of fibroids?

Most fibroids may not show any symptoms. You may not even need treatment. Detection of fibroids is usually the result of comprehensive gynecological examinations.

However, about – 20 of all fibroids can have serious problems. The most common complaint in fibroids is the long and heavy menstrual bleeding. These bleedings can sometimes be very profuse and clotted. It can lead to anemia in patients due to chronic bleeding.

The most obvious symptoms of fibroids;

  • Excessive bleeding during menstrual periods
  • Having light bleeding at certain intervals after menstruation,
  • Visible growth in the abdomen and uterus,
  • Pain in the lower back and coccyx after sexual intercourse and menstrual periods,
  • Frequent urge to urinate
  • It causes constipation due to the pressure it exerts on the intestines.

Risks of fibroids during pregnancy

The risks of fibroids during pregnancy vary depending on the location of the fibroid in the uterus, the size and number of fibroids.

Intramural or submucous fibroids in the uterus cause miscarriage in pregnancy, but also pose the risk of preterm delivery to the expectant mother. In addition, these fibroids may cause an abnormal location in the placement of the baby's position in the mother's womb, and may cause premature separation of the placenta or prevent the contractions of the uterus, leading to bleeding after delivery.

Generally, as a result of detected fibroids, the mother-to-be is delivered by cesarean section.

Although the reason for the formation of fibroids is not known exactly, it is known that they develop depending on the female hormone estrogen. With the increased estrogen hormone during pregnancy, the fibroids present in the expectant mother may tend to grow. Fibroids with this growth of 6 cm or larger are more likely to be diagnosed. Fibroids of this size are more common to grow.

In fibroids that have grown during pregnancy, sometimes as a result of insufficient nutrition of the fibroid, a problem called fibroid degeneration may occur due to disruption in blood circulation. However, severe pain occurs in the abdomen of the expectant mother, in the area where the fibroid is located. The expectant mother is likely to confuse these pains with conditions such as appendicitis, premature separation of the placenta, or the threat of premature birth. Therefore, it is necessary to pay attention to all kinds of abdominal pain during pregnancy. Informing your doctor in such cases is important for both your own health and the health of your baby.

Importance of fibroid diagnosis before pregnancy

The fibroids that will cause the most problems for expectant mothers during pregnancy are those located in the submucous. For this reason, the risks that may occur in terms of diagnosis of fibroids can be prevented by performing controls before pregnancy. Fibroids should be removed with appropriate treatment. While open surgical procedure can be applied for this, vaginal hysteroscopy can also be performed. However, operations to remove fibroids can sometimes cause intrauterine adhesions and obstruction in the tubes after surgery. In this respect, when fibroids are diagnosed before pregnancy, great care should be taken in choosing the preferred method for their removal.

It is absolutely recommended to remove the fibroids that are in subserous and intramural location, those that cause bleeding or other symptoms, and those that are large.

Especially if women have had a problem thought to be related to fibroids in their previous pregnancies, the existing fibroids should be removed before their new pregnancies. Especially women who have had problems such as premature birth or miscarriage should be followed up on their pregnancies.

Is it possible to treat myoma without surgery?

Such a method is available in myoma treatments. Success is achieved in most of the patients who undergo MR-guided focusing of sound waves (MR-HIFU). This non-surgical treatment method is only suitable for one out of four patients with fibroids. In order to achieve successful results in myoma treatments, the problems of the patients must be determined correctly and they must definitely apply the right method.

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