I have fibroids and I don’t want to have an operation, can I get pregnant first?
This question is closely related to the location and size of the fibroids and the presence of symptoms. In simple terms, interstitial and subplasmic fibroids that do not affect the uterine cavity and are less than 5 cm in diameter, in this case it is possible to try to conceive without affecting the outcome of the pregnancy.
After all, surgery has its own risks, and with surgery, you need several months to 1-2 years of contraception to allow the uterus to grow before you can get pregnant, and for older people, you can’t afford to wait.
In the case of submucosal fibroids, interstitial fibroids affecting the uterine cavity or fibroids larger than 5 cm in diameter, it is recommended to remove the fibroids surgically before trying to conceive. Otherwise, you will be prone to infertility or miscarriage.
Fibroids found only after pregnancy ……
There are some special cases where you don’t normally get tested, but you just get pregnant and only when you go for an ultrasound you find out that you still have fibroids. What to do about this!
What to do, if you have fertility requirements, first conservative observation; if you do not want this child, then family planning department to see, abort and then follow up, the surgery, if you do not need surgery, regular check-ups.
What can happen if I get pregnant with fibroids?
If you get pregnant with fibroids, in fact, most of the time there are no visible symptoms.
However, the fibroids will almost always grow. Fibroids are affected by estrogen and progesterone hormones, and when you are pregnant, the levels of these hormones are very high, and the fibroids receive enough nutrients to grow violently, to more than 10 centimeters in diameter, or even larger, and the fibroids grow in size to the third power of the diameter, so you can imagine how much nutrients are needed at this time, which may cause anemia in pregnant women and growth retardation in the fetus.
A growing myoma may affect the fetal position, causing malposition such as breech and transverse position; it may also affect the shape of the uterine cavity, leading to miscarriage and premature delivery; if it presses on the sigmoid colon, it may aggravate constipation during pregnancy; if it presses on the bladder, the feeling of frequent and incomplete urination is serious.
If the fibroid grows too aggressively, it is prone to red degeneration and abdominal pain. Clinically, there is no too good solution for red degeneration of leiomyosarcoma, and conservative treatment with antibacterial drugs can be considered; if there is an aura of miscarriage or preterm labor, birth control drugs can be used. Most of them can be relieved, a few severe ones may not be able to keep the fetus.
Is it possible to remove fibroids while I am pregnant?
This is basically not recommended anymore. Because of the high risks, such as bleeding, uterine rupture, miscarriage, infection, etc., and the small benefits, surgery is not necessary.
Is it possible to have a normal delivery?
In most cases, vaginal delivery is possible.
However, if the fibroids are located in the lower part of the uterus and are large enough to interfere with the birth canal and prevent the fetus from descending, then normal delivery is not possible. This will need to be evaluated by an obstetrician.
It is important to note that larger fibroids may affect labor force and slow labor, and affect uterine contraction after delivery, causing more bleeding after delivery. Therefore, for larger fibroids, it is important to observe them before and after delivery and treat them promptly if necessary.
Can I have my fibroids removed together with my cesarean delivery?
Pregnancy with fibroids is not a reason to have a cesarean section, and most people can do it on their own.
Some people think of removing the fibroids together with the cesarean, so that they can kill two birds with one stone, which I say is a good wish.
The first reason why I don’t advocate doing this is that, as I mentioned earlier, the fibroids almost always grow during pregnancy and the blood supply is rich, so the contraction of the uterus is affected when stripping, which can lead to haemorrhaging and even uncontrollable bleeding.
Secondly, after giving birth, the level of estrogen and progesterone will drop to normal, the fibroids will shrink significantly, to six months or more after giving birth, if the fibroids shrink to the extent that they do not need surgery, it is not better, if there are still indications for surgery, and then to open, the risk is also small, you can also do laparoscopic minimally invasive, why do you need to leave such a big bite of scar on the stomach.
If the fibroids happen to grow near the uterine incision and affect the removal of the fetus, then the fibroids need to be removed first; or if the subplasma fibroids are small and the connection with the myometrium is small, the trauma of removal is small and does not affect the contraction of the uterus, then it is not a bad idea to take the “tumor” by hand.