Are Fibroid Tumors Problematic During Pregnancy
Fibroid tumors are common in women, so they are also common in pregnancy. They are benign (noncancerous) tumors of the muscle of the uterus. Noted more often in black women, they tend to increase in size and number as women age, and then shrink during menopause. No one knows what causes fibroid tumors, but they are almost always not cancerous.
When women come to me for ultrasounds, they are often surprised to hear that they have a small, perhaps walnut-sized fibroid. The hormones of pregnancy encourage fibroids to grow, so what was too small to notice before pregnancy might become visible on an ultrasound during pregnancy.
If you have fibroids during your pregnancy, there are some things to consider. Fibroid tumors can be a problem if:
The tumor is so big that it compresses the baby, which is rare.
It’s under the placenta and restricts blood flow to the placenta, which is not common.
It is large (the size of a softball or grapefruit) and located low enough in the uterus that it is blocking the birth canal, which is also not common.
Sometimes, what is thought to be a fibroid is really a localized contraction of the muscle that goes away by itself. When having an ultrasound, you should be sure that the scan goes on for a few minutes to see whether the muscle contraction resolves itself or whether what’s seen on the scan is a true fibroid.
Sometimes fibroids cause pain if the tumor grows faster than its blood supply. The treatment is pain medication, including Tylenol, codeine or Demerol. Of course, never take aspirin, Motrin, ibuprofen or other related medications when you’re pregnant, even though they are what we usually use outside of pregnancy for this kind of pain.
If you have had surgery to remove a fibroid tumor, it’s important for your doctor to know how it was done. If the tumor was on a stalk and simply cut, the fibroid is generally not an issue in the pregnancy or delivery. However, if the muscle of the uterus was cut, then you will need to be delivered by Caesarean section because there is a risk of the uterus rupturing in labor.
Fibroids rarely cause infertility, although the surgery to remove them can leave scars on the pelvis that can interfere with normal conception.
What’s the bottom line? If you know that you have fibroids, they may grow, but usually are not a major problem in pregnancy. If you need surgery for fibroids, have it done before you get pregnant. Surgery for most fibroids is not a good idea during pregnancy, and due to the high volume of blood flow to the pregnant uterus, we also don’t like to take them out during Caesarean sections.