Fibroids and Pregnancy

With later marriages come later pregnancies. It is not uncommon to see women having their first child in their mid to late thirties today. I had a patient come for a checkup wanting to start her family and an ultrasound scan of her pelvis showed a fairly large fibroid. The previous gynaecologist had told her that it was alright to get pregnant with the fibroid in her uterus so she thought nothing of it. She did not have any symptoms. Fibroids in pregnancy are more and more common nowadays. Whether it affects the pregnancy will depend alot on the position of the fibroid. If it is near the cavity, it may cause a miscarriage, cause the baby to lie in the wrong position or block the passage of the baby at birth. The pregnany is therefore more risky for the baby and mother. The fibroid may grow rapidly due to the sudden surge of pregnancy hormones and this may cause severe pain due to 'degeneration' in the fibroid. The pain would be multiplied if there are several fibroids. Caesarean sections would be more dangerous too because of excessive bleeding or having to cut near the fibroid to get the baby out. The choice for the patient was therefore whether to take out the fibroid first and then try to get pregnant or to get pregnant knowing all the possible problems that it brings. An operation to remove the fibroid meant a wait of a year after before she was able to try for a pregnancy. As she was already in her late thirties, she opted to get pregnant with the fibroid in the uterus.