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All about fibroids and pregnancy!

All about fibroids and pregnancy!


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Fibroids affect one in every four to five blood. How much does the presence of fibroids during pregnancy affect pregnancy? The answer to this question Obstetrics and Gynecology Specialist Op. Dr. Alper Mumcu gives…

What is uterine fibroids?

Uterine fibroids are the most common masses in the female reproductive system. Although one in every 4-5 women has fibroids, three-quarters of patients are unaware that they have fibroids because they do not show any symptoms. In the majority of fibroids, the diagnosis is made during routine gynecological examination or other examination.

Can fibroids affect pregnancy?

Fibroids, often present before pregnancy, can have direct or indirect effects on the course of pregnancy. However, many uterine fibroids show no symptoms during pregnancy and do not cause any problems other than occasional abdominal pain.

The problems that can be caused by fibroids during pregnancy depend on the location, size and number of fibroids. For example, uterine fibroids growing into the uterus or within the uterus can cause recurrent miscarriages.

Fibroids associated with pregnancy cause problems in only 10-30% of women. The most common of these problems is occasional abdominal pain. Due to the rapid growth of the uterus during pregnancy, a reduction in the blood supply of the uterine fibroids occurs. As a result, there will be a decrease in the oxygen and nutrients that reach the myoma and degeneration starts. This condition, called red or carnous degeneration, has no effect other than causing pain and is often seen in mid-pregnancy. In such a case, no treatment other than bed rest, abundant fluid intake and simple painkillers is required. In the presence of degeneration, there may be a bleeding that is not very severe.

Fibroids can cause postpartum hemorrhage as they may adversely affect uterine contraction after birth.
Do fibroids grow during pregnancy?

The fact that fibroids are mostly seen in women of reproductive age and tend to shrink after menopause suggests that these masses are directly related to the female hormone called estrogen. Since pregnancy is a period in which high amounts of estrogen are secreted, it is frequently asserted that fibroids will grow during pregnancy. However, there is not enough evidence to support this argument in the researches conducted to date. In one study, women with fibroids were observed throughout their pregnancy and 80% did not have any growth in fibroids. In some women, even fibroids have been reported to shrink during the course of pregnancy.

Can uterine fibroids harm the baby?

Probably not bile Even if bleeding and pain symptoms occur, your baby is unlikely to be affected. Although there is no harm to the baby, the risk of preterm birth may increase depending on the size and location of the uterine fibroids. However, there is no conclusive evidence. However, if abdominal pain occurs in the presence of uterine fibroids, you should immediately notify your doctor.

It is not the case that the baby's head is below, but the lower buttocks (breech arrivals) or side arrivals are also caused by fibroids. If uterine fibroids are located in the lower parts of the uterus, the chance of normal birth is reduced as it may block the birth canal. All these factors may necessitate delivery by cesarean section.

Rarely, fibroids may cause the separation of the placenta called abrubtio placenta. This is a very dangerous situation, but it is extremely rare.

Can fibroids be treated during pregnancy?

In case of pain, bed rest and treatment with painkillers are often applied. Symptoms usually disappear within a few days. Surgical removal of myoma during pregnancy (myomectomy) is not performed.
How to follow pregnant in the presence of uterine fibroids?

When uterine fibroids are very common, special precaution or follow-up is not required in every pregnant woman. Here, the criterion is the size and location of the uterine fibroids, as mentioned earlier. Close follow-up is recommended in patients with high potential for problems. Especially in case of pain, whether it is due to fibroid degeneration or a more serious cause such as the threat of preterm birth should be investigated. In the presence of the threat of preterm birth, treatment is tried with appropriate methods. For this reason, every woman who has pain should definitely contact her doctor without wasting time.

If the number of uterine fibroids is too high or the location is to obstruct the birth canal, pregnancy is terminated by caesarean section when the term is reached without waiting for birth pains.
Is uterine fibroids removed during cesarean section?

This is a highly controversial issue. Some argue that there is no risk of bleeding because uterine vascularization increases during uterine fibroids. Some authors argue that the number and placement of fibroids are important here.

If the location of the fibroids is not too deep, if the fibroids can be removed from the same incision line as the caesarean section, myomectomy can be performed during cesarean section if there are subserous fibroids that have grown outwards.

Uterine fibroids on the surface of the uterus about 1 centimeter can be destroyed by applying heat with the help of a device called cautery. Whether or not to remove the uterine fibroids during a caesarean section is a decision that the surgeon can make.


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