Understanding the effects and management of uterine fibroids is crucial for ensuring a healthy pregnancy.
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Uterine fibroids can significantly affect pregnancy, leading to complications
Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous tumours that grow in or on the uterus. These growths are common in women of reproductive age and can impact pregnancy in various ways. Athough many women remain unaware of their condition until they experience symptoms or complications during pregnancy. Understanding their effects and management is crucial for ensuring a healthy pregnancy. Uterine fibroids can influence pregnancy outcomes depending on their size, number, and location. Studies indicate that fibroids are present in 3.3% to 10.7% of pregnant women and can lead to complications in 10% to 40% of these cases.
Uterine fibroids can lead to complications during pregnancy. Fibroids are classified into three types based on their location: subserosal (on the outer wall of the uterus), intramural (within the uterine wall), and submucosal (within the uterine cavity). Submucosal fibroids are most likely to affect a person's ability to conceive and maintain a pregnancy as they distort the uterine cavity where a baby grows.
The primary concerns include:
1. Preterm Birth
Women with fibroids have a higher risk of preterm birth, with an incidence rate of around 12.85% compared to 9.43% in those without fibroids.
2. Miscarriage
The presence of fibroids, especially submucosal ones, is associated with an increased risk of miscarriage and recurrent pregnancy loss.
3. Placental Issues
Fibroids can lead to placental abruption (where the placenta detaches from the uterus), placenta previa (where the placenta covers the cervix), and restricted foetal growth.
4. Labor Complications
Larger fibroids may necessitate a cesarean section due to complications they might cause during labor and delivery.
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About 20% to 50% of women of reproductive age have fibroids.
Credits: iStock
Detection and Diagnosis
Fibroids are typically diagnosed through ultrasound, often during routine prenatal visits. They can be detected as early as the first trimester, with most growth occurring in the second trimester. Approximately 68% of fibroids are diagnosed during the first trimester.
Management and Treatment
The management of fibroids during pregnancy focuses on monitoring and addressing symptoms rather than removal, which carries risks. However, in some cases, interventions are necessary:
1. Medical Management
Medications like ulipristal acetate can shrink fibroids and manage symptoms before pregnancy or in the early stages.
2. Surgical Options
Myomectomy, the surgical removal of fibroids, is typically avoided during pregnancy due to the risk of haemorrhage. However, it may be performed concurrently with a cesarean section in selected cases.
3. Minimally Invasive Procedures
Techniques like uterine artery embolization, focused ultrasound surgery, and radio-frequency ablation are available but are generally considered post-pregnancy options due to potential risks during pregnancy.
Impact of Uterine Fibroids Worldwide
Uterine fibroids affect a significant portion of the female population. Globally, about 20% to 50% of women of reproductive age have fibroids, with some estimates going as high as 77% for women over 50. In India, similar prevalence rates are observed, though many women remain unaware of their condition until they experience symptoms or complications during pregnancy.
Awareness and Education
Despite their prevalence, many women are unaware of the potential impact of uterine fibroids on pregnancy. Increasing awareness through education and routine gynaecological check-ups can help in early detection and management, improving pregnancy outcomes and overall reproductive health.
Uterine fibroids can significantly affect pregnancy, leading to complications such as preterm birth, miscarriage, and placental issues. Early detection and appropriate management are crucial. While surgery during pregnancy is rare, medications and careful monitoring can help manage symptoms and ensure healthier pregnancy outcomes. Increasing awareness and regular medical check-ups are vital in addressing this common yet often overlooked condition.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
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