Many women of childbearing age have a tumor that develops in the muscular layer of the uterus - myoma. And revealed during the examination of uterine fibroids during pregnancy can have a significant impact on the process of carrying a child. Although for some women, asymptomatic fibroids have virtually no effect on their daily lives or pregnancy.
How much pregnancy in the presence of fibroids will be problematic depends on the type, volume and localization of this non-cancerous formation.
Is pregnancy possible with myoma?
When asked whether pregnancy is possible with myoma, gynecologists answer in the affirmative, since uterine fibroids are usually not the main cause of reproductive dysfunction, that is, an obstacle to the fertilization of the egg and implantation of the blastocyst into the endometrium of the uterus.
Although, it all depends on the place of development of the pathology or the size of the formation (which varies from the size of a wheat kernel or grape to a large apple). In most cases, submucosa or submucous fibroids and pregnancy that go into the uterine cavity and violate its form are incompatible. Such myomatous nodes are located in the muscles under the endometrium of the uterus, and, having a myoma of this type, it is difficult to get pregnant.
The interstitial or, in other words, intramural myoma and pregnancy arising within the muscular membrane of the uterus (between its layers) are partially compatible. A woman’s large fibroids can also cause infertility: due to squeezing and blocking of the fallopian tubes, or localization when the cervix enters her cavity.
But there are other types of fibroids that have almost no effect on the intrauterine cavity. Thus, compatible with subserous fibroids and pregnancy facing the abdominal cavity. But this does not mean that there will be no problems during such a pregnancy: subserous fibroids can grow to solid sizes, moreover, it can grow in the papillary type, that is, it has a leg (which can create problems, for example, twisting it).
Are uterine fibroids and ectopic pregnancy possible? The answer to this question is also affirmative: the development of ectopic pregnancy due to the presence of fibroids is possible when the formation is localized in the area of the entrance of the fallopian tubes into the uterus and blocks it.
It is also possible to plan a pregnancy for myoma. Moreover, this does not mean a preliminary removal of all nodes: a thorough examination should reveal the nodes that will interfere with the normal course of pregnancy, and doctors recommend getting rid of such entities before pregnancy.
Causes of uterine fibroids during pregnancy
Despite the fact that uterine fibroids are extremely common - with a total frequency of up to 25% at the age of 30-35 years old and twice as many at the age of 50 years - its exact etiology remains unexplained.
Gynecologists associate the causes of these formations, including the causes of uterine fibroids during pregnancy as an intercurrent pathology - with excessive estrogen production (17β-estradiol).
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Risk factors for fibroids: damage to the muscular layer of the uterine wall and its mucous membrane in inflammatory diseases of the reproductive organs, curettage of the uterus (curettage during abortion), diagnostic manipulations on the uterus and appendages, as well as surgical intervention on the pelvic organs. In addition, experts include metabolic disorders (diabetes, obesity, hypothyroidism) as risk factors.
This pathology often has a familial nature (up to 20–25% of cases), which is explained by the inherited point mutations of the ESR1 and ESR2 genes encoding the estrogen receptors and specific mutations of the MED12 gene (encoding a transcription factor of the protein synthesis enzyme).
Pathogenesis is perceived as an increased effect of estrogens on specific nuclear and membrane receptors of sex steroids in uterine tissues (ERα and ERβ), the inadequate expression of which causes changes in the functions of uterine smooth muscle cells (myocytes), stimulates their proliferation and, obviously, provokes a violation of the synthesis of the main myofibrillary proteins (myosin and actin).
In the structure of the multilayer muscular layer of the uterus, there is also an extensive system of blood and lymphatic vessels, and in the extracellular matrix - connective tissue elastin and collagen fibers. Violation of one of the structures, especially if there is multiple fibroids or large fibroids during pregnancy, can lead to a decrease in myometrial function, which reduces and relaxes the uterus, as well as its stretching during pregnancy.
It should also be borne in mind that during pregnancy, significant morphological changes occur in the structure of the myometrium, which are manifested in an increase in the number of myocytes (due to accelerated mitosis), an increase in their size (due to hypertrophy of cell nuclei) and increased collagen production.
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Symptoms of uterine fibroids during pregnancy
At the initial stage of development of most types of this pathology, there are no symptoms. Fibroids usually occur before pregnancy, and the majority of women do not know about it: education is found during a gynecological examination or during an ultrasound examination.
With the onset of pregnancy, the growth of education can begin, and then such symptoms of uterine fibroids during pregnancy as unpleasant feelings of discomfort, pressure, severity or even pain will appear if the formation presses on surrounding organs or pelvic structures. Sometimes these feelings are accompanied by a slight fever and nausea.
When the front wall of the uterus is affected with myoma, urination becomes more frequent, and when pregnancy and nodular myoma of the uterus on the back wall are combined, the problem of permanent constipation arises.
Acute pains in myoma during pregnancy in the lower abdominal cavity with irradiation to the lumbar region can be the result of squeezing a nerve or a manifestation of rebirth of a fibroid into a cyst. The state of acute abdomen with fever and temporary leukocytosis occurs with a rare complication of fibroids - internal hemorrhage in the tumor site (hemorrhagic infarction). And painful cramps in the abdomen or pain of a pulling character are observed when twisting the stem of subserous fibroids.
Pain is the most common sign of fibroids at later stages of gestation and is most often manifested if a large fibroid is formed during pregnancy (> 5 cm).
In the early stages, bleeding during myoma during pregnancy is associated with the localization of the formation: when the placenta forms in the immediate vicinity of the hypertrophied tissue node during submucous myoma. In fact, such bleeding is a miscarriage, that is, spontaneous abortion in uterine myoma.
Also cause bleeding in myoma during pregnancy, when the fibroid is large or grows deep in the myometrium. Gynecologists say that fibroids can cause a recurrent early miscarriage, which happens so early that a woman does not even know that she was pregnant.
Growth of fibroids during pregnancy
According to clinical observations using ultrasound, almost one third of cases show an increase in fibroids during pregnancy - especially during the first ten weeks. The average increase in tumor volume varies from 6 to 18%, but in some pregnant women, fibroid growth is possible by 25-30% of the original volume.
The growth of fibroids during pregnancy depends on the individual characteristics of the woman’s body and occurs under the stimulating effect of a high level of estrogen and other hormones produced by the placenta. Also, an increase in fibroids is largely due to the type and level of placental and pituitary growth factors (CYT) that are present in the blood.
Can myoma dissolve during pregnancy? Experts say that the full involution of fibroids during pregnancy never undergoes, but in almost 8% of cases it can decrease in the third trimester - up to 10%. But after childbirth, when the content of sex hormones in the blood decreases, the myoma node may dissolve.
What is dangerous uterine fibroids during pregnancy?
A tumor found on any period of childbearing poses a certain danger.
The main risks are reduced to:
High probability of abortion on various terms,
The risk of development of isthmic-cervical insufficiency, which threatens with premature birth or late miscarriage, is most often observed with the cervical-ischemic location of the neoplasm nodes,
Placental insufficiency, which threatens to delay the development of the fetus and its hypoxia, is most often observed in the intermuscular arrangement of fibroids, as well as in the presence of a conglomerate of tumors,
Delayed development of the fetus due to malnutrition, the shortage is due to the fact that myoma "steals" the child,
Accelerated growth of neoplasm
Violation of the blood supply of the tumor and its necrosis,
Pelvic vein thrombosis resulting from clamping with large myomatous nodes
Too tight attachment of the placental membrane,
Premature detachment of a normally located placenta,
Ischemia of myometrium, due to increased uterine tone, increased venous outflow and malfunction of the node.
Due to the fact that the number of possible complications is quite high, a woman is recommended to keep the pregnancy only when the risk is low. Indications for preserving pregnancy include the young age of the woman in labor (up to 35 years), the absence of extragenital pathologies, the subperitoneal arrangement of the nodes, their small size and short duration of illness (up to 5 years). In addition, the pregnancy is maintained with a late visit to a doctor and a viable fetus, with prolonged infertility and with the impossibility of interruption.
Popular Questions and Answers
Women of reproductive age who have had fibroids are often asked the following questions:
Does uterine fibroids resolve during pregnancy? The likelihood that a tumor can resolve itself during pregnancy is quite high. It can disappear both during gestation and after childbirth. The doctors associate the degeneration of fibroids with the fact that hormonal changes occur in a woman's body, which against the background of circulatory disorders in the tumor leads to the fact that she dies.
To suspect the process of resorption of the tumor can be on several grounds:
First, it is an increase in the tone of the uterus and an increase in body temperature.
Secondly, it is pain in the area of the node.
Third, changes in blood counts (increased ESR and leukocytes).
Most often, these symptoms are observed for 14 days. Determine, degenerated education or not, you can during the passage of ultrasound.
Can I get pregnant after removing uterine fibroids? After the operation, the chances of conceiving a child are significantly increased. This is due to the fact that in some cases it is myoma that prevents the fertilization of the egg or the attachment of the embryo, especially if its size is sufficiently high. In addition, the tumor greatly complicates the process of carrying a child. With regard to the time period that should be sustained before embarking on planning a pregnancy, it is 1 year. Although it all depends on the individual characteristics of the woman, the complexity of the surgery and the nature of the tumor.
How to treat uterine myoma during pregnancy?
It is important to understand that the period of carrying a child, accompanied by the presence of a disease such as fibroids, may be accompanied by a certain therapeutic effect. Doctors have several treatment goals. This is a reduction in the muscle tone of the uterus, the extension of pregnancy to normal and the possibility of having a healthy baby.
For this purpose, the following medications may be prescribed:
Antispasmodics, namely Drotaverinum, with intramuscular administration, and then oral administration,
Antiplatelet drugs such as pentoxifylline, aspirin, and dipyridamole,
Tocolytics, namely hexoprenaline,
Antibiotics, however, they are prescribed only if there are signs of malnutrition of the myoma node,
With insufficient production of progesterone, it is advisable to take djufaston and tocopherol acetate.
In addition, prevention measures aimed at preserving the life and health of both the mother and the fetus are important. To this end, women are assigned antioxidants and antiplatelet agents that help prevent the formation of placental insufficiency. Such a preventive measure is advisable to the introduction of the 16th week.
It is important to regularly monitor the woman at the doctor to determine not only the state of the fetus and placental system, but also changes from myomatous nodes.
For the provision of antispasmodic, metabolic and antiplatelet effect with a preventive purpose, a woman may be recommended to take Magne B6, Curantila, Actovegin.
If preventive and curative measures do not bring the desired effect and serious complications arise, it is advisable to perform a surgical intervention. Indications for myomectomy in childbirth can be threatened abortion, severe pain with compression of the pelvic organs, eating disorders in the nodes and their gigantic size.
In addition, a woman must be hospitalized, if fetal hypoxia is observed, the course of pregnancy is complicated by placental insufficiency and we are damaging risks.
Often the risk of miscarriage in myoma is observed in the initial stages of pregnancy, in percentage terms it can reach 58%. With regard to the threat of preterm birth, the risk ranges from 12 to 25%. The treatment does not differ from the same treatment for pregnant women who do not have tumors in the uterus.
In order to assess the degree of risk and decide on the need for treatment, ultrasound and dopplerography are shown.
Therapeutic measures during pregnancy with myoma is also the observance of bed rest, a decrease in physical activity. In addition, doctors recommend to refrain from sex, caution will ensure a normal uteroplacental and renal blood flow.
Education: The diploma in the specialty “Andrology” was obtained after passing residency at the Department of Endoscopic Urology of the Russian Academy of Medical Education at the Urology Center of the Central Clinical Hospital №1 of Russian Railways (2007). Here was completed graduate school by 2010.
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Myoma refers to benign neoplasmsthat occur in muscle tissue. The disease can occur with unexpected cell division. The cause of this pathological process is unknown, but there are speculations of specialists that it arises against the background of an increase in the level of estrogen. At the same time, the hormone progesterone stimulates its reverse development. But do not think that the normal hormonal balance of progesterone and estrogen indicates the exact absence of the disease in a woman.
The same can be said about fibroids.Its only difference is that, arising in the muscle tissue, fibroids quickly spread to the connective tissue and develop a formation of a round shape. Usually they are multiple and of different sizes.
Many women of childbearing age are interested in whether pregnancy is possible with uterine myoma. The successful conception of a child should indicate a woman’s normal hormonal background, but this does not indicate the exact absence of her illness. It can simply be combined with pregnancy.
In recent years, increasingly diagnosed with myoma during pregnancy. This is associated with an increase in the age of women in labor. As you know, hormonal imbalances in the body usually begin after 30 years. But diagnostic methods have improved, so it became easier to identify the tumor.
Impact on conception
Fibroids can cause certain difficulties when conceiving a child. The most common factors that cause difficulties during this period are:
- ovulation disorders
- possible squeezing of the fallopian tubes,
- difficulty moving sperm due to this compression.
In itself, a neoplasm cannot cause infertility. But if all other causes were excluded, removal of the formation may increase the chances of getting pregnant. This situation concerns myomas, which in size do not reach the size of a 12-week fetus. If the tumor is larger, it will deform the uterine cavity. In this regard, when removing it, it is very difficult to preserve the fertility function. The reason may be heavy bleeding during surgery, when the need for uterus removal is not excluded.
Development of education at different times
Fibroids during early pregnancy can be dangerous for the mother and baby. This happens in case of contact with the formation of the placenta. In addition, not the last value has the size of myoma nodes. Complications do not occur if these nodes are small.
Most often, the first trimester of pregnancy in a woman ends in a spontaneous abortion. The reason for this may be increased contractility of the uterus. If the fibroid is destroyed, substances are released from it that contribute to muscle contraction, and so does the uterus. At the same time, the woman's blood circulation is disturbed in this genital organ. Also, the cause of miscarriage can be time not identified violations of the endocrine system, chronic diseases such as, for example, cervical hyperplasia.
If the beginning of pregnancy with the disease has passed without complications, then in the later stages it may threaten with early childbirth. This is due to the fact that myoma nodes reduce the amount of space in the uterus. The larger the education, the higher the risk of early labor. Also of great importance is the location of the formation and its connection with the placenta. According to statistics, if a woman has large myomatous nodes, more often she can have a baby with low weight, since the tumor will interfere with the normal delivery of the baby.
Difficulties at birth
In most cases, women with fibroids protracted labor. Very often, these patients are advised to do a cesarean section, since it may not be possible to give birth to the patient. Although education itself should not interfere with the process of birth of the fetus, but large myomatous nodes are often combined with improper presentation of the fetus, while natural delivery is impossible.
There are cases that during a cesarean section, the incision falls directly on the education, then the doctor can remove it. In the case of fibroids during pregnancy, the consequences for the child can be serious. Often there is compression of the head, as a result of which oxygen starvation develops. Sometimes babies are born with torticollis.
If the patient has an education behind the placenta, it can be detached. In the process of birth, obstetricians must take this factor into account. Some postpartum complications are often associated with myoma. To early carry heavy bleeding, to late - the inability of the uterus to decrease to its normal size. Possible development of infectious diseases. Uterine fibroids and pregnancy with fibroids should be strictly observed throughout the entire period of childbearing.
The effect of pregnancy on the tumor
The development of pregnancy is directly affected by increased levels of the hormones estrogen and progesterone. Their level, in turn, affects the development of education. During this period, the muscular layer of the uterus increases, the blood flow in it increases. All this also has an effect on the tumor. A very important factor is the location of the latter.
It is believed that uterine fibroids during pregnancy increases with the fetus. But there is an opinion that this growth is not true, but it seems against the background of a growing uterus. A small increase in education can be observed in the early stages, in the last trimester, it usually decreases in size.
During pregnancy, the destruction of the tumor may be observed. But this is more negative than positive. The destruction of fibroids is often associated with necrosis of its tissues, the appearance of cysts or bleeding. Depending on the location, it can be destroyed both during the carrying of the baby and after the birth.
The first signs of circulatory disorders are:
- pain in the place where the myoma node is,
- uterus tone,
- high ESR,
- increase in leukocytes in the blood.
This condition is observed for 1-2 weeks. Doctors usually prescribe patient bed rest and analgesics to relieve pain. The diagnosis is confirmed in the process of ultrasound.
Surgical intervention is carried out rarely and only in cases of acute deterioration of the patient's condition. In most cases, with such operations, pregnancy can be maintained.
Treatment of the disease
Conservative treatment is to prevent the tumor from growing. Treatment methods will depend on the cause of the formation. Often it can provoke anemia, so it is necessary to pass on time all the studies prescribed by the doctor. For the treatment and prevention of uterine fibroids prescribe:
- iron preparations
- B vitamins,
- folic acid
- vitamins A, E and C,
These drugs, along with a protein diet, have a positive effect on the endocrine system and can reduce the body's sensitivity to estrogen.
In patients with uterine myoma, lipid metabolism is often impaired, which is manifested in an increase in body weight. In such cases, correction of power is needed. Carbohydrates need to be replaced with vegetable fats, add juices to the diet, preferably freshly squeezed.
In the postpartum period, treatment is continued with hormones that contain progesterone. If the growth of education cannot be stopped, surgical intervention is indicated.
We should not forget that in the early stages of detecting a disease, its treatment will be faster and easier. You need to be attentive to your health, and if any disturbing symptoms appear, consult a doctor. Conception and childbearing will be successful if a woman is supervised. Uterine fibroids during pregnancy can have dire consequences for the child. But if the disease is diagnosed in time, the treatment will contribute to the normal bearing and birth of the baby.
During pregnancy, myoma was diagnosed. Passed various surveys, was observed. As a result, it normally carried out and gave birth to a baby, however, they did a cesarean section.
The doctor told me that even with large fibroids, you can normally transfer the entire pregnancy. I just went through prescribed examinations several times to monitor my condition.
In general, my fibroid has resolved itself after childbirth. True, it was small, so the doctor did not see any particular danger for the baby. He said that everything will go away by itself. So it happened.
Changes in the uterus during pregnancy
In the body of a woman during pregnancy there are major changes that allow you to make a baby. The most significant changes in this period occur in the uterus. Pregnancy with uterine myoma of small size can develop without complications, in some cases there is a worsening of the woman’s condition and a threat to the baby, which is caused by the anatomical features and the development of the disease.
The structure of the uterus
Fetal development occurs in the uterine cavity, as it has a structure that ensures the maintenance of pregnancy. The peculiarity of the reproductive organ is its ability to increase in size and good stretchability; after giving birth, the uterus returns to its original state after a few weeks. Multiple uterine fibroids and pregnancy are combined with the fact that a woman has an increase in the size of the uterus, the cause of which is determined by gynecologists.
The uterus consists of three parts: the body of the organ, the neck and the isthmus. The bottom of the uterus is the highest part of the body. During gynecological examinations, the gynecologist controls the location of the uterus, this indicator allows you to identify possible pathologies of pregnancy. The pear shape of the uterus ensures that the fetus accepts the correct position during pregnancy and childbirth.
Uterine walls are formed by three layers:
- The endometrium is a mucous membrane that lines the uterine cavity from the inside. When pregnancy occurs, the thickening of the shell,
- myometrium or muscle layer, which in the absence of pathologies is in a relaxed state. In the process of labor, it begins to decline rapidly. Increased uterine tone during pregnancy can be a dangerous disorder that occurs during stress, inflammatory processes, underdevelopment of the uterus and hormonal imbalance,
- the serous membrane or perimetry covers a large part of the uterus.
When planning a pregnancy, a woman should pay special attention to reproductive health, the state of which is determined by the gynecologist during the examination. During diagnosis, subserous myoma and pregnancy can be detected. Many women may not be aware of the development of the disease for a long time, since at the initial stages the symptoms of the pathology may be absent.
Transformations during pregnancy
Myoma of 3 cm and pregnancy at the initial stage can develop asymptomatically, the deterioration of the condition and the absence of menstruation indicates the process of fetus formation in the early stages. Changes to the reproductive organs are noted by the gynecologist during the examination. These transformations may not be visible to women, as they occur gradually.
A noticeable increase in the uterus occurs by the 5th week of pregnancy, and the organ also takes a spherical shape. At the initial stage of pregnancy, uterine tissue softens. An increase in uterus size in the first trimester is negligible. An increase in abdominal circumference can cause subserous fibroids and pregnancy, an experienced gynecologist will be able to determine the cause of the changes.
During the implantation of the ovum, a woman may develop bleeding that does not have pain syndrome. This symptom can occur when a 5 cm fibroid develops in the uterus during pregnancy, the woman should immediately contact the doctor in charge, as the discharge may indicate a beginning miscarriage.
Preparation for pregnancy
Preparation for pregnancy is a crucial task, in the implementation of which the woman needs the help of an experienced gynecologist. When a woman addresses a medical institution on this issue, a comprehensive diagnosis is carried out, and problems that impair reproductive health are identified.
Myomatosis is a common disease that is detected in patients who have not given birth to a patient, or women who have a small number of pregnancies. Myoma during pregnancy can cause complications or provoke a miscarriage, so regardless of its complications and size, treatment is given. If the tumor is diagnosed at a time when the woman is carrying the child, the doctor can perform a caesarean section and removal of the fibroid at the same time.
A pregnant woman should undergo regular examinations and visit a gynecologist who can identify possible irregularities and preserve the fetus. Modern medicine has safe methods to restore reproductive health. Each patient can receive a preliminary consultation by e-mail and visit a specialist at a convenient time.
The effect of fibroids during pregnancy
Every woman who is preparing for the birth of a child should be attentive to her well-being, if pregnancy develops with a large uterus myoma. Myoma is not a hindrance to the birth of a healthy baby, but it can complicate the course of pregnancy.
The main causes of problems with fertilization, miscarriage and the development of complications of myoma are:
- the tumor closes the entrance to the fallopian tubes, so that the sperm cannot fertilize the egg,
- cervical deformity benign tumors,
- endometrial diseases caused by multiple fibroids,
- deformation of the uterus and a decrease in its size can cause fibroids of 8 cm, and pregnancy can be terminated.
If conception occurred in this disease, complications can occur in any trimester, so a woman should regularly visit a gynecologist.
Pregnancy with uterine myoma small size
If a woman is diagnosed with uterine fibroids 6 cm and less intense manifestations of the disease are absent, and pregnancy in most cases is uneventful. The growth of small nodes in this period stops. However, some women who have benign growths in the uterus may experience slight pain, accompanied by nausea. Painful sensations are characteristic for the first and second trimesters.
Pregnancy with uterine myoma large size
The question of the influence of myoma formations during pregnancy is not fully developed. However, experts have identified possible complications that develop when carrying a child against the background of myomatosis.
The main conditions of pregnancy for myoma are:
- high probability of birth up to 37 weeks is observed with multiple nodes or close proximity of the tumor to the placenta,
- miscarriages in submucous myoma,
- placental abruption and bleeding,
- deformation of the uterine cavity, as a result of which the fetus is not positioned correctly,
- Caesarean section is performed quite often for women with myomas. However, uterine mime is not among the indications for this operation,
- weakness during childbirth and postpartum bleeding occur in women with myomatosis quite rarely. The data on these complications are considered to be highly controversial by highly qualified specialists.
Pregnancy with uterine myoma small size rarely accompanied by complications. As a result of hormonal changes in the body, knot growth can occur.
Symptoms of the disease during pregnancy
Benign tumors in the uterus can develop without symptoms or have pronounced signs. Unpleasant manifestations of the disease are observed in 30% of patients. Often the disease is detected during a routine inspection.Women who rarely visit a gynecologist may develop 10 cm fibroids, and pregnancy in this case will not occur or will be accompanied by serious complications.
In the modern world, you can make an appointment by phone and visit the clinic at a convenient time. The success of treatment in myomatosis depends on the adequacy of therapeutic measures and their timeliness. In pregnancy, complicated by this disease, there are situations when patients need emergency, emergency care, which is provided by experts from the best clinics.
If there are signs of fibroids, it is necessary to consult a gynecologist for examination and to determine possible ways of treatment. During pregnancy, the disease is characterized by the following symptoms:
- frequent urination, impaired defecation. These signs appear during pregnancy with fetal growth, but the cause of their development may be the pressure of the tumor on the bladder and rectum,
- intestinal disorders
- increased sweating
- pain in the vagina, in the lower abdomen,
- an increase in the volume of the abdomen in early pregnancy,
- vaginal discharge with an unpleasant smell
- headaches and dizziness,
- low blood pressure
- pale skin
- high fatigue.
These signs may be mistaken for a woman for manifestations of pregnancy. However, if you feel unwell, you should immediately contact a medical institution for quality care. If uterine fibroids develop, symptoms during pregnancy depend on the type of tumor, its location, size, and individual characteristics of the organism.
Pregnancy with multiple large fibroids
Numerous myoma formations have a negative impact, both on the onset of pregnancy and the process of carrying a child. Symptoms of multiple myomatosis and node behavior are different. The main symptoms of the disease are pain and vaginal discharge, with the progression of the disease worsens the overall condition of the patient.
If multiple uterine fibroids and pregnancy have been identified, then the woman should often be examined. Heat and intense pain occur rarely during pregnancy, these symptoms may indicate a twisting of the leg and the death of the node, which is a serious danger to the fetus.
Treatment of multiple nodes requires an integrated approach, the application of which is impossible for pregnant women. Embolization of the uterine arteries is highly effective. This procedure allows you to reduce the size of all nodes and eliminate the likelihood of relapse. The positive impact of the procedure is noted by patients and endovascular surgeons in the first hours after its implementation, then the symptoms and the size of the formations gradually decrease.
Risks for mother and fetus
Uterine fibroids 9 cm during pregnancy is a danger to the fetus and mother. Large tumors before planning pregnancy are removed by various methods, since they can cause a spontaneous miscarriage, and also prevent the onset of pregnancy. If conception occurs in this pathology, then there is a serious obstacle to normal delivery, which is eliminated using various methods of modern medicine.
Myomatous node in the first trimester of pregnancy
Many patients turn to gynecologists with the question of whether pregnancy is possible with multiple myoma and large nodes. In this case, conception is possible, but if it has occurred in a woman with a tumor in the uterus, then she needs to contact a specialist for examination and consultation. The need for a comprehensive diagnosis is that the tumor deforms the uterine cavity, violates the tissue and blood supply to the affected area.
In the first trimester of pregnancy hormones change, which can provoke a rapid growth of a benign tumor. By the end of the first period, the growth of nodes ceases. If the pathological process continues to progress, complex therapy is carried out, the selection of components of which takes into account their degree of negative impact on the fetus.
When attaching the placenta near the myoma node in the first trimester, the probability of abortion is high. In addition, the disease adversely affects the general condition of the expectant mother, as she is experiencing excessive fatigue, heaviness in the lower back, pain is possible.
Removal of fibroids during pregnancy is carried out in exceptional cases, for example, during caesarean section. In the first trimester, the patient may be given medication therapy to eliminate symptoms and stop the growth of nodes.
Features of the course of the disease in the second trimester of pregnancy
In the second trimester, a tumor in the uterus can cause abnormal fetal development. Large nodes squeeze the fetus, resulting in violations of the spine. In addition, the amount of nutrients intake decreases, as the neoplasms absorb substances in the blood.
With myomatosis, the fetus is likely to develop certain disorders:
- cranial deformities
- curvature of the spine, in particular, the cervical spine,
- violation of the structure of the limbs,
- increased intracranial pressure
- reduced child weight
- disturbances in mental development.
Risks to the mother during pregnancy on the background of fibroids are that uterine bleeding may occur, and placental abruption will occur. A rare type of tumor is calcified fibroids and pregnancy can also successfully develop in this form.
Dying off the node in the absence of pregnancy is considered by experts to be a favorable outcome of the disease, however, when a pregnancy occurs, it can be a serious danger to both the baby and the mother.
Myoma during pregnancy and childbirth
With the development of fibroids in the uterus during pregnancy and childbirth can be complicated. Common complications during pregnancy with myomatosis are:
- dying off of nodes
- delayed discharge of water
- impaired uterine contractile activity,
- uterine bleeding.
Timely embolization of the uterine arteries helps prevent negative consequences. This procedure has no contraindications, since its use uses a hypoallergenic drug.
When a pregnant woman who develops fibroids applies, the gynecologist performs an examination, the results of which are necessary for developing treatment tactics and maintaining pregnancy. When choosing the most optimal methods, the patient's age, the size and direction of growth of tumors, their number is taken into account.
Maintaining childbirth in this disease is a difficult task. In labor, the ability of the uterus to contractions may sharply decrease due to the development of a large benign tumor. The location of the node in the cervix prevents the child from passing through the birth canal, and to remove this problem, fibroids are prescribed during cesarean section.
Removal of fibroids during pregnancy
When carrying a baby, intensive treatment of myomatous formations is not carried out, since there is a high probability of spontaneous miscarriage, rupture of the organ or premature birth. To reduce the manifestations of the disease, medications may be prescribed by the attending physician, which have a weak effect, which reduce pain and other symptoms.
An important factor affecting the development of the fetus, is the psychological state of the mother. Highly qualified specialists during the interaction with the patient help her to overcome the anxiety associated with childbirth and illness, and also teach self-regulation techniques in stressful situations.
Removal of fibroids at caesarean section is considered gynecologists the best way of delivery. With this combination of surgical interventions, the likelihood of complications and the need for long-term rehabilitation is high.
Myomectomy is an organ-sparing surgery, however, when puffing is removed in this way, patients have relapses. Surgical intervention is recommended when planning a pregnancy so that a tumor in the genital organ does not cause complications when carrying a child.
In modern clinics, endovascular surgeons perform uterine artery embolization, at which intervention is minimal. The tumor is replaced by connective tissue gradually, so a year after the procedure it is possible to conceive. Experts note the high efficiency of this method in multiple neoplasms and large nodes that are not amenable to conservative therapy. If a woman has been diagnosed with large fibroids and pregnancy does not occur, embolization is recommended, the reviews of which are positive.
Removal of fibroids at caesarean section
A cesarean section is a surgical procedure in which an incision is made on the anterior abdominal wall and body of the reproductive organ through which the child is removed. Caesarean for uterine myoma involves the removal of myoma nodes or uterus. The preservation of the reproductive organ is an important task for which various methods have been developed in modern medicine, one of which is the embolization of the uterine arteries.
Surgical removal of memes during cesarean is practiced by many gynecologists and surgeons. However, this operation has certain indications:
- dying off of a tumor before delivery,
- inflammation of the peritoneum due to torsion of the leg of the tumor,
- the presence in the uterus of a large submucosal node,
- large myomatous nodes that prevent free access to the birth canal,
- the patient is over 35 years old
- disruption of the functioning of nearby organs caused by a large benign tumor,
- suspicion of rebirth fibroids, the probability of this process is almost zero,
- large fetus, partial placenta and other factors that complicate the process of childbirth.
Caesarean for myoma can be prescribed by a gynecologist also for multiple nodes and anomalies of the development of female genital organs. Caesarean section together with myomectomy is performed under anesthesia or anesthesia. Rehabilitation is an important stage after surgery. For the most effective recovery, safe methods are used, which are indicated to the patient in this state.
Caesarean section for myoma: operation features
The initial stage of the operation is the incision of the anterior abdominal wall and the inspection of the genital organ. Then the child is removed from the uterus and afterbirth. If a large tumor is detected during the examination, it is immediately removed and the integrity of the damaged tissues is restored.
A sterile dressing is placed on the suture area, besides that, regular wound healing is necessary for rapid wound healing. If a myomectomy was performed during a cesarean section, the recovery period is the longest. For successful rehabilitation, it is necessary to respect the diet, the use of dietary products that are easily digested, adherence to work and rest time, limiting physical activity.
After surgery, the patient is placed in the ward, where medical staff regularly monitors her condition and performs the necessary procedures.
During embolization of the uterine arteries, the patient does not need a long-term recovery, since the damage is minimal. This procedure allows you to successfully treat myomatosis both at the planning stage of pregnancy and after childbirth. Reviews of patients who have undergone embolization, are positive, they managed to make and give birth to a healthy child.
In today's society, women can get a preliminary consultation by e-mail, as well as make an appointment with specialists. When treating patients with the problem of developing fibroids during pregnancy, specialists choose the most effective methods to reduce the manifestations of the disease, preserve the pregnancy and reduce the negative impact on the mother and fetus.
What is fibroids and why does it occur
Myoma is a hormone-dependent benign neoplasm growing from the smooth muscle elements of the uterus.
Its main causes are elevated ovarian hormones and impaired metabolic processes. This condition can occur when:
- Physiological fluctuations in the synthesis of ovarian hormones: pregnancy, perimenopause.
- Diseases of the endocrine glands: hormone-active tumors and ovarian cysts, pathologies of the adrenal glands, thyroid gland.
- Central nervous system lesions affecting the hypothalamus and pituitary gland.
- Smoking and alcoholism.
- Chronic stress.
- Long-term use of hormonal drugs.
Under the influence of adverse conditions, atypical cells appear in the uterine muscle layer, which begin to randomly divide, forming a knot. It can grow in the thickness of the myometrium (interstitial), goes to the surface of the organ (subserous), or go into the cavity (submucous).
For a long time, the disease is asymptomatic and is detected when the node reaches 30 mm or more in diameter. The main manifestations of fibroids are:
- Long, plentiful monthly.
- Soreness and discomfort in the lower abdomen.
- The compression of the tumor next to the intestine and bladder, provoking a violation of bowel movement and urination.
- Acute pain and signs of inflammation of the peritoneum with malnutrition in the nodes.
When these symptoms occur uterine neoplasm requires mandatory elimination.
Are fibroids and pregnancy compatible?
Myomatous nodes, located among the muscle fibers of the uterus, violate its architectonics. Myoma in the isthmus of the uterus prevents the flow of sperm into the organ cavity and the fallopian tubes, where the fertilization of the egg cell should take place. Also, conception is impossible if the node grows, blocking the lumen of the fallopian tubes.
The tumor, impeding the contractility of the uterine muscles, disrupts the normal menstrual cycle. However, it is often accompanied by endometriosis - the growth of the uterine epithelium outside its inner layer. This minimizes the chances of safely combining pregnancy with myoma without medication.
If fertilization did occur, the nodes that have a submucosal arrangement can interfere with the complete attachment of the blastocyst, from which the embryo and its location are formed. This is the cause of miscarriages at different periods and violations of fetal development of the child.
And changes in the uterus during pregnancy
The gestation period is accompanied by alterations in the whole body. The uterus undergoes significant changes: its epithelial lining thickens, muscle fibers elongate and hypertrophy, allowing the body to stretch strongly as the size of the fetus increases.
These changes are controlled by hormones that actively produce the ovaries, and after 12 weeks of gestation and the placenta. And often it provokes an intensive growth of a hormone-dependent pathological structure.
About pregnancy complications with fibroids
The percentage of spontaneous abortions during early pregnancy is significantly higher in women with this pathology than in women without knots in the myometrium. At the same time, the risk of miscarriage is significantly increased in case of numerous myomatous tumors.
With adherence of the placenta to areas of fibroids, there are frequent cases of detachment, which is accompanied by pain, heavy bleeding and subsequent death of the fetus.
For the same reason, delays and anomalies of fetal development are often observed. Large nodes in the uterus can squeeze the child, leading to various deformities.
The second third of the gestational period may be complicated by placental insufficiency, causing insufficient oxygen to the fetus (hypoxia). Placement of the placenta to the cervical canal contributes to frequent bleeding and the threat of spontaneous abortion. Also with the further development of pregnancy, the occurrence of preeclampsia is possible. This is a pathological condition characterized by:
- Increased pressure.
- The appearance of protein in the urine.
- Swelling of the face and limbs.
- Neurological disorders.
With the development of hypertensive crisis and convulsions (eclampsia), urgent delivery is required regardless of the timing of gestation.
In the third trimester of pregnancy, fibroids can cause an abnormal position of the child. Large nodes prevent him from taking a head position to the entrance to the small pelvis. The child is transversely or feet forward, which will significantly complicate the process of childbirth. This may be an indication for cesarean section with myoma.
Is it possible to confuse myoma with pregnancy
Often, myoma nodes are symptomatically similar to the period of gestation. You can confuse them with pregnancy by the following symptoms:
- Delay regular menstruation.
- Spotting in the intermenstrual period.
- Enlarged belly.
If these symptoms occur, you should definitely consult a doctor for a correct diagnosis.
Diagnosis of a tumor during pregnancy
Most precisely, a uterine tumor can be detected by ultrasound examining the uterine cavity. Confusion on ultrasound can only occur if the submucous myoma on the pedicle has a small volume.
It can be taken for the embryo. In such cases, it is necessary to determine the concentration of hCG (human chorionic gonadotropin) in the urine or blood. This hormone is a marker of pregnancy and in myoma its concentration is close to zero.
How to distinguish
Pregnancy from myoma tumors can be distinguished by the following features:
- Weekly increase in the concentration of hCG in the blood and urine.
- The emergence of a bluish tinge of the vagina and cervix, softening of the tissues of the body when probing.
- On ultrasound: determination of fetal heartbeat from 6-12 weeks, perturbations from 16 weeks of gestation.
Important! Delay of menstruation, bloody spotting from the genital tract, pain and discomfort in the abdomen, as well as an increase in its size - a reason for a mandatory visit to an obstetrician-gynecologist. Only a doctor will be able to determine if the patient has fibroids or pregnancy.
Can fibroids dissolve itself during pregnancy?
In the practice of some obstetricians and gynecologists, there have been cases when a pregnant woman has myoma resolved. However, such situations are extremely rare.
As a rule, pregnancy gives impetus to a more intensive growth of uterine nodes due to changes in hormonal levels.
Therefore, all women with a history of this pathology should plan pregnancy and, if necessary, treat the pathology at the pregravid preparation stage.
Major hazards during gestation
The most common complications of a tumor during gestation are:
- Low attachment and placenta previa.
- Threats of miscarriage.
- Underdevelopment of the placenta.
- Compression of the fetus tumor nodes, leading to deformities.
- The development of preeclampsia.
- Incorrect (transverse, foot) position of the fetus to the entrance to the small pelvis, impeding the process of birth.
How to behave properly during gestation
Pregnant with myoma tumors should not panic. The main thing that a woman can do to prevent the development of complications is to follow all the recommendations of the obstetrician-gynecologist.
In order to prevent the growth of the tumor, it is necessary to undergo ultrasound of the pelvic organs and fetus in the prescribed by the doctor.
If you experience any disturbing symptoms (blood from the genital tract, abdominal pain, worsening of general well-being) you should definitely visit a gynecologist.
Women with tumors, especially pregnant women, are not recommended to be in the sun for a long time, to carry out warming procedures on the lower abdomen and lower back. It should adhere to proper nutrition and give up bad habits. And you should definitely avoid stress and unnecessary excitement.
Treatment of pathology during pregnancy
Hormone therapy, prescribed to eliminate the nodal uterine formations, is impossible during pregnancy. Therefore, treatment of the tumor is carried out only symptomatic in the event of clinical manifestations.
Important! Any drug therapy during pregnancy must be agreed with the obstetrician-gynecologist. Many drugs are forbidden to take during gestation.
When is a tumor removal operation performed?
During pregnancy, uterine nodes are removed according to the following indications:
- The nodes of significant volumes and their intensive growth.
- Twisting the base of myoma formation, accompanied by the death of tissues.
- The lack of result from drug therapy.
- Severe pain syndrome.
The optimal and most safe period for myomectomy for mother and fetus is 15-19 weeks of gestation. The operation requires a wide incision (laparotomy). The tumor is excreted and excised, an ultrasound scan is performed immediately after the intervention to assess the viability of the fetus. After removal of fibroids during pregnancy, vaginal birth is contraindicated.
Natural birth or cesarean section
Births with myoma can occur naturally with a small diameter of the node, its localization near the bottom of the uterus and the absence of mechanical barriers to the birth of the fetus.
Births with myoma by cesarean section are carried out at the lower segment location of large nodes, the occurrence of complications and after myomectomy.
Prenatal and postpartum period
Safe to give birth with myoma is possible. The birth process must be supervised by a qualified medical staff. At the same time monitoring of fetuses and heartbeat is constantly monitored. In case of complications, emergency operative delivery is applied. After birth, uterine bleeding and delayed afterbirth are more common. Therefore, it also requires constant medical supervision.
Consequences for the child
The main danger of fibroids to the fetus - it is the compression of its large nodes, provoking deformation and deformity. As well as in the vicinity of the placenta with pathological tissues, blood circulation between the uterus and the placenta is impaired, leading to a delay in fetal development and oxygen starvation of varying severity.
However, with medical monitoring of the gestation period, such complications are extremely rare. Despite all the frightening possible consequences, fibroids and childbirth are compatible if the woman is under the supervision of doctors and fulfills all their instructions.
M iome causes infertility
The tumor-like nodes of submucosa and intermuscular localization have the greatest adverse effect on the fertile function. They prevent the full attachment of the blastocyst to the uterine wall, causing infertility. At the same time, myomectomy and hormonal therapy, carried out before pregnancy, increase the chances of a successful conception and carrying a child.