When the Year of the Monkey meets the Year of the Full-blown Second Child, the ranks of those preparing to become mothers are getting bigger and bigger. However, once fibroids are found, people who are preparing for pregnancy are worried about what to do. It is very simple, just go to a specialist for an evaluation. The general principle, I will also give you here.
I am in good health, but why do I have fibroids?
Many of you usually have good health and normal menstruation, but when you go for an ultrasound to prepare for pregnancy, a fibroid is found on your uterus. Why is that?
In fact, what you don’t know is that most of the time fibroids just grow quietly until you go for an ultrasound one day and then you know that there is an extra mass in your body.
Fibroids can be divided into three main categories based on their growth site: submucosal fibroids, interstitial fibroids, and subplasmalemma fibroids. The latter two types of fibroids are the most common, but rarely show symptoms. Submucosal fibroids and some interstitial fibroids close to the uterine cavity tend to cause increased menstruation, leucorrhea, and even large submucosal fibroids that run outside the vaginal opening, causing pain in the lower abdomen and scaring people into giving birth to tumors. Especially large fibroids can sometimes press on the neighboring organ next door and have corresponding pressure symptoms.
Is it possible to get pregnant with fibroids?
This question is closely related to the location and size of the fibroids and the presence of symptoms. Simply speaking, interstitial and subplasmic fibroids that do not affect the uterine cavity and have a fibroid diameter of less than 5 cm, in this case it is possible to try to conceive directly 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 back 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, it is easy to be infertile or to have a miscarriage.
Fibroids found only after pregnancy ……
There are some special cases where you don’t normally have checkups, but you just get pregnant and only when you go for 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 on the surgery, do not need surgery on regular checkups.
What can happen if I get pregnant with fibroids?
If you get pregnant with fibroids, in fact, most of the time there are no obvious 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 get enough nutrients that some of them grow violently, to more than 10 centimeters in diameter or even larger, and the volume of the fibroids grows according 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 fibroid 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 birth; 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 myoma grows too fiercely, it is prone to red degeneration and abdominal pain. Clinically, there is no too good solution for red degeneration of leiomyosarcoma, you can consider conservative treatment with antibacterial drugs; if there is an aura of miscarriage or premature birth, you can use birth control drugs. Most of them can be relieved, a few severe ones may not be able to keep the fetus.
Is it possible to remove fibroids during pregnancy?
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, resulting in slow labor, and affect uterine contractions after delivery, causing more bleeding after delivery. Therefore, for larger fibroids, it is important to observe them before and after delivery and deal with 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 have it on their own.
Some people think of removing the fibroids together with the cesarean section to kill two birds with one stone, which I say is a good wish.
The first reason why I don’t advocate this is that, as 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, and it is easy to hemorrhage, or even uncontrollable, and finally the uterus has to be cut, so it’s not worthwhile to take these risks in order to strip a fibroid.
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.
So don’t make it difficult for the obstetrician to help you peel the fibroids during the dissection.
When the preparation for pregnancy meets “fibroids”, it is actually very simple, you will all know!