How Can I Shrink My Fibroids During Pregnancy

A small number of pregnant women have uterine fibroids. If you're pregnant and have fibroids, they probably won't cause you or your baby any problems.

Fibroids can increase in size during pregnancy. Most of this growth occurs from blood flowing to the uterus. In combination with the additional demands that pregnancy places on the body, the growth of fibroids can lead to discomfort, pressure or pain. Fibroids can increase the risk of:

• Miscarriage (when the pregnancy ends before the 20th week)
• Premature Birth
• Breech birth (where the baby is born in a position other than head down)

Fibroids don't always grow during pregnancy. In most studies, the majority of fibroids remained the same size. Spontaneous shrinkage has been noted in almost 80% of women within 6 months of pregnancy. After pregnancy, uterine remodeling can affect fibroids and create a natural therapy during the reproductive years. This could explain the protective effect of parity or number of pregnancies on fibroid risk.

Rarely, a large fibroid can block the opening of the uterus or prevent the baby from entering the birth canal. In this case, the baby will be delivered by caesarean section. In most cases, even a large fibroid will get out of the way of the fetus as the uterus expands during pregnancy. Women with large fibroids may lose more blood after childbirth.

Frequently, fibroids do not need to be treated during pregnancy. If you have symptoms such as pain or discomfort, your doctor may prescribe rest. Sometimes a pregnant woman with fibroids needs to stay in the hospital for a while because of pain, bleeding, or the threat of preterm labor. Very rarely, a myomectomy can be performed on a pregnant woman. After a myomectomy, a cesarean delivery may be required. In most cases, fibroids decrease in size after pregnancy.

Attempted delivery is not recommended in patients at high risk of uterine rupture, including patients with previous classic or T-shaped uterine incisions or extensive transfundal uterine surgery. Since a transmural incision can also be made in the uterus during myomectomy, it was often treated in the same way. There are no clinical studies that specifically address this issue; However, one study reported no uterine ruptures in 212 deliveries (83% vaginal) after myomectomy (74).

Pooled data from multiple laparoscopic myomectomy case series involving more than 750 pregnancies identified one case of uterine rupture (39, 40, 75-77). Other case reports have described the occurrence of uterine rupture before and during labor (78-80), including rare case reports of uterine rupture far from delivery after traditional abdominal myomectomy (81, 82). Most obstetricians allow women who have undergone hysteroscopic myomectomy for type O or type I leiomyomas to go into labor and give birth vaginally; However, there are case reports of uterine rupture in women who experienced uterine perforation during hysteroscopy (83-85). It appears that the risk of uterine rupture in pregnancy after laparoscopic or hysteroscopic myomectomy is low. However, due to the serious nature of this complication, a high index of suspicion must be maintained when pregnancies are treated by this procedure.

What are the effects on pregnancy?

Most women will not experience any effects from fibroids during their pregnancy. However, a 2010 review suggests that 10 to 30 percent of women with fibroids develop complications during pregnancy. Researchers note that the most common complication of fibroids during pregnancy is pain. It is most common in women with fibroids larger than 5 centimeters and in their last two trimesters.

Fibroids can increase your risk of other complications during pregnancy and childbirth. These include:

restriction of fetal growth. Large fibroids can prevent a fetus from growing fully because there is less space in the uterus.

placental abruption. This occurs when the placenta detaches from the uterine wall because it is blocked by a fibroid. This reduces vital oxygen and nutrients.

Early delivery. Pain from fibroids can cause uterine contractions, which can lead to premature birth.

Caesarean section  estimates that women with fibroids are six times more likely to need a caesarean section (C-section) than women who don't have these growths.

locking position. Due to the abnormal shape of the cavity, the baby may not be able to align for vaginal delivery.

miscarriage. Research finds that women with fibroids are twice as likely to miscarry.

What are the effects of pregnancy on fibroids?

The majority of fibroids do not change in size during pregnancy, but some do. In fact, according to a 2010 review, a third of uterine fibroids can grow in the first trimester. Fibroid growth may be influenced by estrogen, and estrogen levels increase during pregnancy. This can lead to growth.

However, in other women, fibroids may actually shrink during pregnancy. In a 2010 study, researchers found that 79 percent of fibroids that were present before pregnancy decreased in size after delivery.

How Are Fibroids Treated During Pregnancy?

During pregnancy, treatment for uterine fibroids is limited due to the risk to the fetus. Bed rest, hydration, and mild pain relievers may be prescribed to help expectant mothers manage symptoms of fibroids.

In very rare cases, women in the second half of pregnancy can have a myomectomy. This procedure removes fibroids from the outside of the uterus or from inside the uterine wall while leaving the uterus intact. Fibroids that grow in the uterine cavity are generally left in place because of the potential risks to the fetus.

What are the symptoms of fibroids?

You may not have any symptoms of fibroids. If you have symptoms, the most common symptoms are:

• Heavy or painful periods
• Bleeding between periods (spotting)
• Anemia caused by heavy or prolonged bleeding
• Extended periods
• Bloating or slight pressure in the lower abdomen
• Pain during sex
• Lower back pain
• Constipation
• Reproductive problems, including infertility, miscarriage, and preterm labor
• Frequent urination
• Difficulty emptying the bladder

Fibroids can be felt during a pelvic exam. If your doctor suspects you have benign growths, they may do an imaging test, such as order an ultrasound, for example, to confirm that the growths are actually fibroids and nothing else.

How is the view?

Uterine fibroids can affect your fertility. They can also affect your ability to successfully carry a pregnancy. However, most women do not experience fertility problems or pregnancy complications from these tumors.

If you have fibroids and want to start a family, talk to your doctor about your treatment options and your risks. Together you can both decide what is safest for your future pregnancy.

While you can't prevent fibroids, a healthy lifestyle can lower your risk. Likewise, living a healthy lifestyle, which includes maintaining a healthy weight, can lower your risk of fertility problems and high-risk pregnancies.