Pregnancy is often thought to be one of the most special times in a woman’s life and is usually filled with excitement and joy as she and the rest of her family anticipate the arrival of their newest member. For women with uterine fibroids, the journey to becoming a mother may not be very smooth because benign fibroid tumors can create complications.
Today we are going to talk about large fibroids and pregnancy and some of the challenges that can arise when they are present during this time of anticipation.
Who Can Be Affected By Fibroids?
Uterine fibroids do not get much press, which is a bit surprising because of the high number of women who are affected by them. Almost 80% of women develop them before they are 50, but many are unaware because they do not have any visible symptoms. Other women suffer from complications from fibroids that affect their ability to function several days a month at work and home.
Unfortunately, it is still a mystery what causes the regular smooth muscle cells of the uterus to change into abnormal ones and begin forming these hard, round rock-like growths, but researchers have learned some important information regarding who is most at risk and what can impact the growth of fibroids.
Women who are in their childbearing years are at risk for fibroids, and women of color are at increased risk and are more likely to develop them at an earlier age. Other contributing factors in developing fibroids include obesity, vitamin D deficiency, and exposure to excess estrogen.
What Types Of Fibroids Cause Issues With Pregnancy?
Intramural fibroids and submucosal fibroids are the culprits that can create challenges when a woman is pregnant or trying to become pregnant. Intramural fibroids grow inside the walls of the uterus in the muscle, and submucosal fibroids grow in the lining of the uterus. Both of these types of fibroids can distort the shape of the uterus, and if they grow large enough, can create trouble for both the mother and the baby.
How Can Fibroids Interfere In Pregnancy?
Many fibroid-afflicted women do not have any issues when pregnant or giving birth, but out of the approximate 25% of women who do, around 5% of them have serious fibroid-related pregnancy complications. Most complications that arise are due to large fibroids during pregnancy or delivery, and they can even cause issues while the woman is trying to conceive.
Let’s look at these three scenarios related to pregnancy and the challenges that fibroids can create during each one.
- Conceiving a baby can be challenging for some women who are trying to become pregnant, and in a number of cases, the issue is directly related to submucosal or intramural fibroids.
Because they develop inside the uterine lining, submucosal fibroids are the ones that pose the highest risk of preventing conception from taking place. If a woman has large submucosal fibroids, her chance of achieving pregnancy is 70% lower than average. This type of fibroid can alter the structure of the uterus so much that the embryo is not able to implant in the uterus securely.
Another issue that can occur with a large submucosal fibroid during pregnancy is that it may exert enough pressure on the fallopian tube to seal it off, keeping the sperm from successfully reaching the egg or keeping an egg from making it safely down the fallopian tubes into the uterus to implant.
While submucosal fibroids are the ones that are most guilty of interfering in conception, intramural fibroids can also affect fertility. Numerous or large intramural fibroids can prevent pregnancy because they can also impede the fertilization process by creating blockages for the sperm or egg, and they can also compromise the shape of the uterus and prevent successful implantation.
- Problems During Pregnancy
- One fact that researchers have uncovered is that uterine fibroids thrive in an estrogen-rich environment. When a woman gets pregnant, the estrogen production in her body significantly increases, and this can make any fibroids that exist grow larger. This normally happens in the first three or four months when the hormone levels are rapidly increasing. In addition to the increase in the estrogen hormone, during these initial months, your body also produces more blood, which increases your total blood volume by around 40%. Your heart works a bit harder to keep up with the increase in blood and your blood flows a bit faster. Fibroids need a blood source to thrive, and they grow in response to estrogen exposure, which explains why the first trimester of pregnancy is the perfect environment for fibroids to grow large.
Large fibroids during pregnancy can exacerbate the usual side effects of pregnancy, contributing to digestive issues, constipation, cramping, frequent urination, and more. When numerous fibroids are present or they are over 6 cm, it can lead to more serious issues. Large submucosal or intramural fibroids can invade the space that is intended for a growing fetus and prevent it from developing properly, resulting in miscarriage. Since fibroids need a blood supply, they can also hijack a significant amount of blood from the fetus, which can have serious consequences and prevent the pregnancy from reaching full term.
- Complications During And After Childbirth
- Large fibroids can cause issues during conception, pregnancy, and during childbirth. Your uterus is designed to produce different types of contractions, depending on the circumstances. During your period, your uterus contracts to get rid of the lining it is not going to use, during childbirth these contractions get stronger to push out the baby, and after childbirth, it creates contractions to restore your uterus to its normal size. Large fibroids can prevent your uterus from functioning the way it was intended and can cause serious complications, such as losing too much blood after delivery.
Women with large fibroids during pregnancy can experience a breech birth, their water can break too early, they may experience preterm labor, it can result in low-birth-weight babies, and complications can arise like placenta previa or placental abruption. Depending on the size and location, large fibroids can influence how the baby is positioned or can be blocking the path of a normal vaginal birth, requiring a C-section delivery for the safety of the mother and baby.
A Large Fibroid During Pregnancy May Cause An Emergency Situation
Many times, after the fourth month of pregnancy, the estrogen production reduces to normal levels, and any fibroids that were growing may begin to gradually reduce in size and will no longer be a threat. However, another issue that can arise with a large fibroid during pregnancy is a condition called necrobiosis. It occurs in less than 25% of cases that involve a pregnant woman with fibroids, but it is important to be aware of it.
This condition occurs when a fibroid that has grown and gotten big during the first four months of pregnancy starts to rapidly reduce in size and degenerate due to the lack of a sufficient blood supply. The degeneration process can cause severe abdominal pain, bleeding, throwing up, and a high temperature. In rare cases, it may become an emergency.
If you have been diagnosed with fibroids and are pregnant, your doctor will monitor your condition closely to stay abreast of any potential complications.
Uterine Fibroid Embolization
If you have a history of fibroids and are having issues becoming pregnant or wish to become pregnant and have a history of large fibroids, you should take a look at the non-surgical procedure called uterine fibroid embolization (UFE). The best way to ensure a pregnancy that is not complicated by fibroids is to get rid of them before you have a baby.
This procedure is done in an outpatient facility and does not involve a stay in the hospital. It eliminates every type of fibroid, including intramural and submucosal, which can be deeply embedded and are the ones that most often interfere with fertility and pregnancy.. After the 45-minute UFE procedure, you can go home with only a bandaid to begin your short recovery time.
Within three months, most patients are free from heavy bleeding and periods that last forever, and they are no longer hostage to fibroids that interfere with their schedule. Additionally, many of the patients who were having issues conceiving became pregnant after UFE.
At the Atlanta Fibroid Center, there is a wall that is full of adorable baby pictures sent in by former patients who had babies after having UFE. There is no reason to half-live your life or forego the experience of motherhood because of fibroids.
Call us today and let us tell you about your option to get rid of fibroids without having to sacrifice your uterus or your chances of becoming a mother. UFE is safe, quick, and over 90% effective, so you have nothing to lose by trying it before resorting to invasive surgical techniques. Get in touch with us today for an appointment. It just may change your entire life!