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Fibroids in pregnancy - what you need to know

Fibroids in Pregnancy FAQs

What are fibroids?

Fibroids are non-cancerous (benign) growths which can either develop inside or outside the walls of the uterus (womb). They tend to vary in size and quantity, sometimes a woman may have one or more fibroids at the same time. As many women don’t experience symptoms, it is impossible to give statistics and how many women suffer from fibroids, but it is possible according to the data available, that from 50% to 80% of women have had fibroids.

As we get older, we have a higher chance of getting fibroids, up until the menopause. The reason for this is that fibroids are linked to hormones, and develop from puberty to menopause.

Fibroids usually develop very slowly over the years. Although a definitive cause hasn’t been entirely discovered, fibroid growth has been linked to the oestrogen and progesterone hormones, which can trigger their growth and development. When we reach our menopause, as our hormones change, then normally fibroids will start to shrink.

What are the different types of fibroids?

There are four different types of fibroids, which are named depending on their location.

Outside the womb: Subserous fibroids develop from the womb’s outside wall and grow into the space in the pelvis

On the muscle wall of the womb: Intramural fibroids grow in the womb’s muscle wall

The inner wall of the womb growing into the space inside the womb: Submucous fibroids grow from the womb’s inner wall into the space inside the womb

Stalk type fibroids: Both subserous and submucous fibroids can develop on a stalk. When this occurs they are called pedunculated fibroids.

What are the symptoms of fibroids?

Very often fibroids can exist without any obvious symptoms. As they become larger, then symptoms may be noted, these can include:

– Swelling in the abdomen (tummy)

– A feeling of pressure or pain in the pelvis

– Heavy menstruation (periods) that can last longer than normal – this may also lead to anaemia, causing dizziness, fatigue and shortness of breath

– A large fibroid can press on the bowel or bladder. So if you feel you need to urinate more frequently, this could be a symptom. Or if it is pressing on the bowel, you may suffer from constipation.

– Fibroids can be a cause for infertility.

If you are currently experiencing any of these symptoms, you should see your doctor.

How are fibroids diagnosed?

When you go to your doctor, he/she will ask about your symptoms and your medical history. The doctor will examine the lower abdomen and will also carry out a vaginal examination. This investigation is carried out with gloves and lubricant, as your doctor gently feels for anything in the womb or cervix. While doing this, the doctor will place their other hand on the lower part of the abdomen, to apply some pressure.

In the case that your doctor believes you may have fibroids, you may be sent for further tests.

An ultrasound scan: a scan is carried out that looks at the womb from the outside, via the lower abdomen. Additionally, you may be scanned using the device that is inserted into the vagina, to investigate the area from the inside. Although this may feel a little uncomfortable, it shouldn’t be painful.

You may have a blood test to find out if you have anaemia.

A hysteroscopy is an examination to look inside the womb. A hysteroscope is used to do this. This is a narrow tube-like telescope, which has a camera. During a hysteroscopy, the doctor can also take a small sample of tissue (biopsy) at this time. If small fibroids are present, it may be possible to remove them during a hysteroscopy. The procedure is carried out either with a local anaesthetic or a short general anaesthetic may be administered.

MRI – a magnetic resonance imaging scan can show your fibroids in greater detail, and may be carried out before surgery.

Laparoscopy – a small incision is made in the abdomen, to insert a small camera, which can then show the surgeon how the outside of the womb and inside of the abdomen look. During a laparoscopy, small tissue samples can be taken (biopsies).

Fibroids can also be diagnosed during a gynaecological examination, which you may undergo for a different medical reason, or alternatively if you are examined because you are having trouble conceiving.

What are the potential issues & treatment of fibroids in pregnancy?

In some cases fibroids which are present in pregnancy can lead to problems, such as difficulties during labour, or baby’s development. Fibroids that cause abdominal pain during pregnancy, may carry a risk of premature labour. If the fibroids are large and are blocking the vagina, a caesarean section may be required. In more rare cases, fibroids can lead to miscarriage. Larger fibroids may lead to infertility, and this also depends on where they are positioned.

Painful fibroids in pregnancy are frequently treated with bed rest, ice-packs, and if necessary medication. In general, symptoms subside in a few days. If your doctor needs to prescribe medication, he/she will choose the safest option available for you.

Further reading:

Contemporary Management of Fibroids in Pregnancy

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This is my second visit to Merrion Fetal, I was very pleased on both occasions. Lovely quiet waiting room, appointment was on time. The 20-week scan is very detailed we enjoyed watching our baby on the large TV screen. We got some beautiful photos. The nurse was very pleasant and talked us through all the measurements and anatomy. I would highly recommend this scanning clinic.”

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Highly recommend! We had an early scan due to a little scare at the start of pregnancy and then another at 12 weeks to make sure all was good again. Helen who was scanning on both days was fantastic. We felt totally relaxed and un-rushed while she took her time finding the best angle of baby to get us the clearest pictures as keepsakes all while making sure everything was perfect with baby. She reassured us throughout and I can honestly say it was the best money we ever spent getting both scans done.

Please let Helen know we are 18 weeks now and flying along Highly recommend!

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All articles on the blog and website are intended as information only. Please do not consider any of the information provided here as a substitute for medical advice. At all times seek medical advice directly with your own doctor and medical team.

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