Uterine fibroids are a very common disease in women, it is also a benign tumor related to hormones, usually occurring in the reproductive age, reaching a peak at the age of 49 perimenopause, statistics in the Chinese population suggest that up to 1/3 of women will develop fibroids, and in the reproductive age of 20-40, 2-8% of women will have fibroids combined with pregnancy. The older the age, the higher the chance. Today we will talk about what to do in case of a pregnancy with fibroids. In general, if fibroids are pregnant, in the early stage of pregnancy, with the large increase of estrogen secretion, fibroids will appear to grow rapidly (usually 2-3 times larger by the meridian), and after 3 months, with the balance of estrogen and progesterone ratio, fibroids will be relatively stable. Usually the fibroids will shrink after delivery. In early pregnancy, the child is more likely to miscarry because of the presence of fibroids, but it is not easy to assess whether the miscarriage is caused by fibroids. As mentioned in the previous article, if it is a submucosal fibroid, it should be considered to be dealt with before pregnancy. So the occurrence of early miscarriage with fibroids does not constitute a reason to necessarily treat the fibroids surgically before considering pregnancy. Red degeneration of fibroids during pregnancy is a common complication of fibroids during pregnancy, mainly manifested by abdominal pain during pregnancy, followed by the possibility of contractions, the incidence of red degeneration is about 10-15%, mainly due to the relative ischemia and necrosis of fibroids after estrogen stimulation of fibroid growth. Not every patient will have a miscarriage when red metaplasia occurs, but most patients will be relieved after conservative treatment. Red metaplasia is a benign lesion and can be treated with medication. Due to the special nature of pregnancy, many doctors are not familiar with the treatment of red metaplasia during pregnancy. In most cases, it is possible to get relief and to pass the whole pregnancy smoothly. Myomectomy is not usually used during pregnancy to solve the problem of red degeneration. If a patient has a history of myomectomy in the past, there is a 5 per 1,000 chance of uterine rupture during pregnancy due to uterine scarring. Many people worry about whether the child will be deformed because of the fibroids, but in general, it is not. If the fibroids are not growing into the uterine cavity and pressing on the child, there will not be too much pressure to cause deformity. In general, if the fibroids are located in the lower part of the uterus, affecting the descent of the fetus and causing obstruction of the birth canal, a cesarean delivery should be considered, but if not, a cesarean delivery may not be necessary. When there are fibroids present, there is an increased chance of postpartum hemorrhage. In case of a cesarean delivery for other reasons, should I have my fibroids removed at the same time as the cesarean delivery? From the patient’s point of view, of course, they would like to solve both problems in one operation, but in general, removing the fibroids at the same time as the cesarean section increases the risk of intraoperative bleeding and postpartum hemorrhage, and the doctor’s skill and attitude become very important factors that influence the decision. If I were your doctor in charge, I would try to solve both problems in one operation if possible to avoid the trouble of another operation in the future, but of course the risks and the skills required by the doctor are a challenge. In conclusion, pregnancy with uterine fibroids is a relatively complex problem that requires gynecologists, obstetricians and patients to face together.