Since the “comprehensive two-child” policy has been implemented in Guangdong this year, more patients with fibroids have been visiting hospitals to ask similar questions. The most important thing is that you should not be afraid of having a baby with fibroids, but you should remove the fibroids first and then get pregnant or abort the baby.
In fact, uterine fibroids are the most common benign tumors in women during their reproductive years. Pregnancy does not cause fibroids to become malignant, and not all fibroids can affect fertility. Before making a decision, it is advisable to listen to a specialist to avoid fertility impairment due to surgical trauma.
Ms. Yau, 40, has just conceived her second child. The family was happy to hear the news.
But Ms. Qiu was anxious. It turned out that she had fibroids a few years ago, but they were not large and the doctor told her that they would not affect her fertility. Now, as she conceived, the tumor began to grow. “Will it affect the baby’s growth? Will it cause a miscarriage? Will it become a malignant tumor?” Ms. Qiu was full of worries and dilemmas.
Uterine fibroids are the most common benign tumors in women during their reproductive years. Pregnancy does not cause fibroids to become malignant, and not all fibroids can affect fertility. Those with fibroids who want to have a second child should be careful about making the decision to “remove the fibroids before getting pregnant” or to “abort to keep them safe”. Before making a decision, it is important to listen to the advice of a specialist so that fertility is not impaired due to surgical trauma.
Two types of one-sided perceptions
1, in many women’s minds, the uterus is a fertile ground for life, once the growth of fibroids, it means that fertility will be affected. Some women are so scared that they go to the doctor and ask to have it removed as soon as they find out that the uterus has grown 2~3 cm sized fibroids.
Comment: “This perception is biased. Fibroids are one of the influencing factors of infertility, but the relationship between fibroids and fertility is also two-way.” On the one hand, some fibroids do cause infertility or interfere with pregnancy. On the other hand, pregnancy may also affect fibroids that are already present. With the hormonal stimulation of pregnancy, fibroids can increase in size.
2. Some women have heard that when they are pregnant, fibroids can be affected by hormones to become larger, resulting in fetal compression and life-threatening risks.
Comment: “This understanding is also one-sided. After pregnancy, fibroids can increase in size, but they do not grow indefinitely. For example, some 5 cm-sized fibroids may grow to the size of 8 cm, and then they will not get bigger and do not pose a threat to fetal development.” If the size of fibroids before pregnancy is under 8 cm, it is possible to prepare for pregnancy normally as long as the growth is not in a dangerous location. Generally speaking, fibroids that grow on the surface of the uterus, in the base of the uterus, do not pose a threat to the safety of the fetus.
Recommendation.
Not all fibroids cause infertility, and many patients are able to conceive and have children with tumors.
For women of childbearing age, especially older women, if fibroids are found when they are trying to conceive, there is no need to rush treatment as long as the fibroids are not large and the location does not affect the pregnancy, but to try to conceive first. Surgical treatment of fibroids, after all, can cause trauma and scarring of the uterus, with the risk of inducing infertility or rupture of the uterus after pregnancy. Generally speaking, fibroids that are small and without any symptoms do not require surgical treatment, but only regular checkups and close monitoring of their changes.
For women who are interested in having a second child, surgery should be more cautious. “Women in their 30s and 40s have a higher rate of fibroids, and if they are removed first, they not only risk complications, but also face a situation where time does not wait.” He pointed out that after surgery, the endometrium needs time to heal, and for senior “chasing two” mothers, “an inch of gold can’t buy an inch of time” and fertility can’t afford to run out.
Two types of cases should be considered to cut fibroids first
For patients with uterine fibroids who are preparing for pregnancy, the doctor will only recommend surgery if the following two types of conditions occur.
One is infertility caused by fibroids. If the fibroids are not growing in a dangerous location and there are no abnormalities in the woman’s health but she is unable to conceive a child, then it is important to consider that the fibroids may have caused the infertility and surgery can be attempted.
Secondly, if the fibroid is too large, above 8-10 cm, or grows in a special area that may affect pregnancy, surgery is required.
Specifically, fibroids that are huge, grow in the uterine cavity, under the mucosa of the uterus, or close to the endometrium are likely to interfere with conception and should be considered for surgical treatment. If the fibroids are huge and do require surgery, care should be taken to carefully suture them during surgery, and the timing of postoperative pregnancy should be determined by the size, depth, and location of the fibroids. During pregnancy, close observation and regular maternity checkups are necessary. In case of a dangerous situation, the pregnancy must be terminated in time, and uterine rupture can be avoided as much as possible.
In fact, the chances of uterine rupture after myomectomy are very low, “do not have to worry too much, but must not be taken lightly.”
The actual fact is that you can prepare for pregnancy six months after surgery
The 36-year-old citizen, Ms. Liu, had her uterine fibroids removed a year ago, out of concern for the scarred uterus, she intends to slow down two or three years before preparing for pregnancy, but is worried about aging ovaries, time does not wait for people, and is very anxious inside.
”There is no need to wait two or three years before preparing for pregnancy after surgery. The risk of developing a scarred uterus is very low, and as soon as the endometrium grows back, you can prepare for pregnancy.” For well-positioned fibroids, the lining usually grows back three months after the surgery.
If it is a subplasmalemma or interstitial myoma, you will need to wait about six months. However, if the trauma is large after surgery, especially if the fibroids are removed to penetrate the uterine cavity, the time to conception may be extended appropriately. If infertility occurs after surgery, fertility can be achieved with the help of assisted reproductive technology if necessary.
Four, myoma red degeneration is not “cancer”
Some uterine fibroids are like leeks that grow again and are prone to recurrence. Some patients are worried that the recurring fibroids may become malignant and become malignant tumors. Some patients with fibroids who are pregnant have red degeneration of the fibroids, causing abdominal pain and fever, which also worries some patients.
In fact, uterine fibroids are benign tumors that increase in size during pregnancy mostly due to red degeneration, which occurs due to ischemia, necrosis, hemolysis, thrombosis, embolism and hemolyzed blood infiltrating into the tumor. The patient usually recovers in about 1 to 2 weeks after conservative treatment, so there is no need to worry about it.
Some women with recurring fibroids choose to have their uterus removed after completing their “fertility plan”. This preventive treatment is “unnecessary” if it is purely from the perspective of preventing fibroids. Fibroid removal can be performed to preserve the uterus while removing the tumor. At the end of menopause, the fibroids will stop growing as hormone levels decline due to the effects of hormone depletion.