Uterine fibroids can be detected in pregnant women as well as non-pregnant women. Hormones that regulate periods, particularly oestrogen, are known to cause fibroids. They increase in size slowly over the years, but when oestrogen levels in the body rise, their rate of growth increases – this is why they are often detected in pregnant women.
They are detected during an ultrasound or can be detected during a pelvic exam when the long fibroids cause the uterus to change shape.
Some common signs of this disorder are pelvic pressure or pain, frequent urination, constipation and backaches, heavy vaginal bleeding, or leg pains.
The most common types of uterine fibroids are:
- Intramural fibroids: the most common type of fibroids that develop within the muscle walls of the uterus. Causes the uterus to appear bigger, heavy or painful periods and fertility problems.
- Submucosal fibroids: these fibroids grow just under the inner lining of the uterus. They alter the lining of the uterus, reduce fertility, and cause heavy or painful periods.
- Subserosal fibroids: these grow on the outside of the uterus. They may bulge or extend into your pelvis, putting pressure on the bladder or bowel.
- Cervical fibroids: they develop in the neck of the uterus or cervix.
In most cases, fibroids do not affect or hamper pregnancy. However, submucosal fibroids are the most likely type to affect baby-making. They can distort the uterus, and interfere with embryo implantation, whether by natural conception or IVF.
In some cases, the risk of miscarriage and premature delivery does increase slightly in case of fibroids. They can occasionally cause the baby to be in an abnormal position for delivery. They can also stall labour, or, if they’re located in or near the cervical opening, they may block the baby’s passage. All of these reasons increase the chances of having a caesarean delivery.
Doctors in most cases would recommend trying out natural pregnancy for a year or two in case the woman is suffering from fibroids. However, if the willing mother is above 35, then in most cases, different fertility treatments are sought.
Surgery to remove fibroids does improve chances of a healthy pregnancy and works better for submucosal fibroids than for intramural fibroids.
There are different types of fibroid-removal surgeries. Some common ones are:
- Myomectomy – a surgical process carried out by keyhole surgery using a laparoscope or hysteroscope.
- Removing the lining of the uterus – a non-surgical procedure called endometrial resection or endometrial ablation. It is suitable for the treatment of submucosal fibroids, which have grown in the inner layer of the uterus.
- Cutting off the fibroid’s blood supply – it is called uterine artery embolisation and is done using a magnetic resonance imaging (MRI) scan. A plastic plug is inserted into the vessel to cut off the blood supply to the fibroid. The fibroid then shrinks and may disappear altogether.
- Destroying fibroid tissues – it is a procedure called myolysis and can be carried out with keyhole surgery using a laparoscope or hysteroscope.
- Alternatively, drugs like gonadotrophin-releasing hormone can be administered which help reduce the levels of oestrogen in your body. These can be taken as a nasal spray, a monthly injection, or as an implant under the skin.