Uterine Fibroids and Pregnancy

Uterine Fibroids and Pregnancy

Fibroids are almost always non-cancerous masses that grow inside of a woman’s uterus and are composed of renegade muscle cells. There are, however, several types of uterine fibroids, as well as different sizes. They can range in size from the tip of an eraser on a pencil, to something as large as a football. The five main types of fibroids are Intramural, Sub mucosal, Pedunculated and Subserosal, and are classified according to where inside of the uterus they are located. Here is a description of each.

  • Intramural Fibroids-These are fibroids that first develop inside of the uterine wall and then expand, making the uterus feel much larger than it normally would. These are also the most common type of fibroids. The symptoms that usually come with this particular type of fibroid are pelvic pain, frequent urination, pressure, back pain and a heavy menstrual discharge.
  • Sub mucosal Fibroids-This type of fibroid develops just underneath the lining of the uterine cavity, and is the least common type of fibroid. The most common symptom for these types of fibroids is a heavy and rather extended menstrual cycle.
  • Cervical Fibroids-These fibroids grow in the neck of your uterus, better known as the cervix. When these particular fibroids develop, they can actually change the shape of the cervix, which can cause it to lengthen. And if it continues to grow, it can even push the uterus upwards. The symptoms that go with these fibroids are abdominal pain, heavy bleeding during your period, anemia, (due to the larger amount of blood loss and pain) dizziness and weakness.
  • Pendunculated Fibroids-This fibroid grows on a stalk, and can actually develop inside or outside of the uterus. Some symptoms related to these fibroids involves pain when the stalk is twisted, cramping, and some pressure being put on to the uterus and other organs, as well as the possibility of bleeding between periods.
  • Subserosal Fibroids-These particular types of fibroids develop in the outer part of the uterus and then simply continue to grow outward. The most common symptom for these fibroids usually involves some pain because of both their pressure and size on other organs that are close by.

Fibroids are usually discovered during a routine visit to your doctor for a pelvic exam, with the doctor feeling lumps in your uterus and then sending you for either an ultrasound or CT scan to make certain. Either one will allow your internal organs to be clearly seen and are non-invasive. If neither one of these tests comes up with an answer and you are still having problems with conception or pain, etc., then your doctor may recommend that you have either a hysteroscopy or a laparoscopy. The hysteroscopy will let a doctor see the inside of your uterus through a viewing tube that is inserted into your vagina, and while not non-invasive, is still not truly surgical. A laparoscopy, however, is a surgical step, which will require general anesthesia and a small cut in your body that will be somewhere underneath the navel. Through the cut, the doctor will then insert a tube carrying a tiny camera on it and look around at the inside of your uterus.

Fibroids are not usually dangerous, but they can be an issue when it comes to conception. And though they do not always affect fertility or pregnancy, they certainly can put up some road blocks on the path to motherhood. Here are some of the problems that uterine fibroids can cause a woman who is trying to become pregnant.

  • Changes in the position of the vaginal opening to the uterus or the cervix, because of fibroids that are located above it. This usually happens with cervical fibroids and may affect the amount of sperm that can then journey through the cervix.
  • When the fallopian tubes become blocked by fibroids.
  • Sub mucosal fibroids can hamper a pregnancy by preventing the implantation and growth of an embryo inside of the uterus, either naturally or through the process of IVF (In Vitro Fertilization.)
  • They can also make changes in the actual shape of the uterus, which can then tamper with the sperms’ movement.
  • Changes that occur in the uterine muscle that can keep an embryo or sperm from moving.
  • They can alter the flow of blood to the uterine cavity where the embryo implants.
  • In the case of uterine fibroids, sometimes trying to remove the problem actually causes a problem with fertility also. This happens in instances of surgery where the endometrial cavity is entered into and later, a post-operative adhesion forms within the uterine cavity. It can also happen when having a myomectomy performed due to how bloody they can be, creating a good chance that abdominal adhesions will form.

As far as fibroids interfering once a woman has already conceived, usually the problems are not too severe. It most often involves abdominal cramping or light vaginal bleeding. The baby is not usually affected even if you happen to experience some symptoms, although some problems do occur on rare occasions. These problems usually include a substantial amount of bleeding, stalled labor, having the baby put into an uncommon position for delivery, (such as breech) placental abruption (the placenta breaks away from the uterine wall before delivery, causing the fetus to not receive enough oxygen) or in the case of the fibroids being near the cervical opening they could possibly block the baby from passing. Most of these issues just make the chance of a cesarean section instead of natural birth, a more likely scenario. In some cases, having fibroids can cause a greater risk of both preterm labor and miscarriage, although this usually depends upon how many you have, what type and what size they are.

The most common ways to deal with fibroids are these:

  • Surgical removal of the fibroids. One option is a hysterectomy, which means removing the uterus. And the other is a myomectomy, which is the removal of a collection of fibroids or the largest ones and then sewing the uterus back together.
  • The blood supply leading to the fibroids themselves can be cut off.
  • A uterine fibroid embolization, which is a minimally invasive procedure and involves the use of radiology treatment for the fibroids themselves.
  • An MRI-guided focused ultrasound surgery that is done while you are inside the MRI scanner. It shows the doctor the exact spot of the fibroid and then the ultrasound transducer focuses sound waves into it, which then heat and destroy small areas of the fibroids tissue.
  • Medication that is able to temporarily shrink the fibroids.
  • Myolysis, which is basically a laparoscopic procedure where a laser or electric current eradicates the fibroids, as well as shrinks the blood vessels that fuel them. Another procedure that is very similar in nature is called cryomyolysis. The main difference being that instead of heating the fibroids it freezes them instead.
  • Endometrial ablation and resection of sub mucosal fibroids. This particular procedure is performed with a specialized instrument that is inserted into the uterus and uses the option of heat, electric current, hot water or microwave energy to destroy the lining of the uterus. The end result will be that your monthly cycle will completely stop, or that it will, at the very least, reduce your monthly flow.
  • Some women have also found success with all natural solutions as well. One good option is a product called, “Fibroid Miracle”.

Uterine fibroids usually hit women within the 30-40 year age group, but they can appear at any age after the beginning of puberty. At some point in their lives, 3 out of 4 women will probably develop this problem but it is almost unheard of for it to turn cancerous and has no association with an increased risk of uterine cancer. African-American women are at a greater risk, however, along with girls who got their menstrual period before the age of 10 and a family history that shows them. Women who are less likely to develop fibroids are women who have had several pregnancies that made it past the 5 month mark and women who take birth control pills.

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