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Is a caesarean deliver necessary if there is a fibroid in the cervix?

Q: I am seven months pregnant and have just been diagnosed as having a 2 cm myoma (fibroid) in my cervix area. I have been told that a c-section will be necessary, and that the myoma will be removed at the same time as the c-section is performed. I have been prescribed medication to reduce swelling etc and told to bed rest. Is it advisable to remove the myoma during the c-section? (I have heard scary stories on this subject). Is it advisable to abstain from sexual activity until after delivery after this diagnosis? If normal intercourse is not advised, are other forms of sexual activity also precluded (specifically achieving orgasm by other methods i.e. non-penetrative)? A little embarrassing, but your advice will be appreciated.

A:I have read your message with great interest, and wish to make the following comments. The finding of a myoma of 2 cm diameter, whatever its location, should not have any influence on the course of labour and delivery. It should NOT be seen as an indication for a caesarean section. If a caesarean section should be performed for any OTHER reason, the myoma should NOT be removed at that time (because of the risk of haemorrhage), unless it should be situated in the incision made in the uterus. There is NO reason whatsoever to implement any treatment for the fibroid at this time. There is no shadow of evidence that any medication will reduce the size of a myoma during pregnancy. Furthermore, there is not the slightest reason to observe bed rest or to abstain from sexual intercourse. Orgasm does not cause women to go into labour prematurely.

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