Pregnancy is a transformative journey, but for women with uterine fibroids, it can bring additional concerns. Uterine fibroids are non-cancerous growths in the uterus that vary in size and can impact fertility, pregnancy progression, and delivery. 

Studies suggest that up to 10% of pregnant women have fibroids, though many experience no complications. However, depending on their size, location, and number, fibroids can sometimes lead to discomfort, preterm labor, fetal growth restrictions, or even miscarriage. 

Understanding how fibroids behave during pregnancy is crucial for managing symptoms and ensuring a safe delivery. This guide offers key insights into fibroids in pregnancy, potential risks, management strategies, and when to seek medical advice.

10 Essential Insights on Uterine Fibroids During Pregnancy

Uterine fibroids in pregnancy can be a cause for concern, but they do not always lead to adverse pregnancy outcomes. While some pregnant women with fibroids experience no complications, others may face challenges based on fibroid growth, size, and location. 

Understanding how fibroids develop complications during pregnancy can help expecting mothers take preventive measures and manage their condition effectively. 

This guide provides in-depth insights into the relationship between fibroids and pregnancy outcomes, from potential risks to management strategies.

1. Fibroids Are Common in Pregnancy

Research suggests that many women of reproductive age have uterine fibroids, and about 10%–30% of pregnant women may develop them. The exact cause remains unclear, but hormonal changes, genetic factors, and blood supply to the uterine wall play a role.

While most women with fibroids have a healthy pregnancy, larger fibroids or those near the uterine cavity may lead to pregnancy complications like placental abruption, preterm labor, or fetal growth restriction. Regular physical exams and ultrasounds are crucial to monitor fibroid symptoms and assess pregnancy outcomes.

2. Fibroids Can Vary in Size and Number

Type of Fibroid	Location in Uterus	Potential Impact on Pregnancy
Intramural Fibroids	Within the uterine wall	May increase risk of preterm labor, cesarean delivery, or pregnancy loss.
Submucosal Fibroids	Inside the uterine cavity	Can cause heavy bleeding, fibroids develop complications, or interfere with placenta previa.
Subserosal Fibroids	Outside the uterus	Usually do not affect pregnancy but may cause severe pain if they grow rapidly.
Pedunculated Fibroids	Attached to the uterus by a stalk	Can twist, causing acute pain and requiring fibroid treatment.

Multiple fibroids or large fibroids increase the likelihood of uterine contractions leading to preterm delivery or placental abruption.

3. Most Pregnancies Progress Without Major Issues

Despite the presence of fibroids in pregnancy, many women successfully carry their babies to term. The risk of pregnancy loss is higher in cases where fibroids larger than 5 cm interfere with the uterine cavity, birth canal, or placenta grows over them.

A healthcare professional will typically recommend regular ultrasounds and non-invasive monitoring to ensure a healthy pregnancy.

4. Fibroids Can Grow Due to Pregnancy Hormones

During early pregnancy, estrogen and progesterone levels rise significantly, sometimes triggering fibroid growth. This can cause smaller fibroids to enlarge and fibroids located near the placenta to become problematic.

However, in some cases, growth occurs rapidly, leading to degeneration, where the blood supply to the fibroid is cut off. This results in severe pain, especially during the second trimester, and may require nonsteroidal anti-inflammatory drugs for relief.

5. Possible Complications Depend on Location and Size

Not all fibroids in pregnancy lead to complications, but the risk is higher if they interfere with:

• Placental function (placental abruption or placenta previa).
• Uterine contractions, leading to preterm labor.
• Fetal growth restriction due to limited space in the uterine cavity.
• Premature rupture of membranes, increasing the risk of preterm delivery.

A healthcare professional may recommend modified fibroid treatment approaches depending on these risks.

6. Fibroids Can Affect the Baby’s Position

When large fibroids grow near the birth canal, they can affect pregnancy by:

• This causes breech positioning and increases the likelihood of cesarean delivery.
• Blocking the cervix, preventing vaginal delivery.
• Pressing on the uterine wall reduces space for fetal movement.

In cases where fibroids may obstruct the baby’s passage, fibroids removed via laparoscopic myomectomy may be considered before conception.

7. Pain and Discomfort Are Common Symptoms

Pain from fibroids in pregnancy is usually due to:

• Fibroid degeneration, where the fibroid outgrows its blood supply.
• Rapid fibroid growth, stretching the uterus.
• Pressure on nearby organs causes severe pain in the lower abdomen.

Nonsteroidal anti-inflammatory drugs may help, but severe cases require hospitalization for IV fluids and pain management.

8. Regular Monitoring Is Essential

For pregnant women with fibroids, regular ultrasounds help track:

• Any fibroid growth affecting the uterine cavity.
• Risks of placental abruption or preterm labor.
• Changes in fibroid symptoms, like vaginal bleeding or uterine rupture.

Frequent check-ups with an interventional radiologist or OB-GYN ensure that any pregnancy complications are detected early.

9. Most Treatments Are Delayed Until After Delivery

Unless fibroids develop complications, removing fibroids during pregnancy is rare. Instead, doctors focus on fibroid treatment after childbirth.

Common post-delivery treatments include:

• Nonsteroidal anti-inflammatory drugs for pain management.
• Laparoscopic myomectomy for fibroids larger than 10 cm.
• Interventional radiologists may perform uterine artery embolization in severe cases.

If fibroids may increase the risk of future pregnancy issues, surgical procedures are considered.

10. Fibroids Often Shrink Postpartum

After childbirth, fibroids shrink naturally due to:

• Decreased estrogen and progesterone levels.
• Reduced blood supply to the uterine wall.
• Natural uterine contractions restore the uterus to its pre-pregnancy size.

However, in cases of postpartum hemorrhage or uterine rupture, fibroids removed surgically may be necessary.

How Do Fibroids Affect Pregnancy?

For pregnant women, uterine fibroids can be a cause for concern depending on their size, location, and growth. While some women experience no complications, others may face risks like preterm labor, placental abruption, and cesarean delivery. 

The presence of fibroids in pregnancy can affect pregnancy outcomes, labor, and delivery. Large fibroids near the uterine cavity or birth canal may require medical intervention to avoid adverse pregnancy outcomes. Let’s explore how fibroids develop complications in different stages of pregnancy and labor.

1. Possible Impact on Conception

Many women with fibroids can conceive naturally, but fibroids located near the fallopian tubes or uterine cavity can block fertilization or implantation. Submucosal fibroids, for example, grow inside the uterine cavity, making it difficult for an embryo to attach.

• Can fibroids prevent pregnancy? Yes, if they distort the uterine cavity or interfere with blood supply to the embryo.
• Do fibroids affect fertility treatments? Fibroid growth can reduce the success of IVF by limiting embryo implantation.
• Will removing fibroids help? Laparoscopic myomectomy may be recommended for fibroids larger than 5 cm if they block the uterine wall or tubes.

A healthcare professional may recommend surgery or fibroid treatment if conception is difficult.

2. Risks to the Mother and Baby

Pregnancy with fibroids may lead to various pregnancy complications, depending on their position and size. Smaller fibroids often do not cause issues, but multiple fibroids or fibroids larger than 10 cm can create high-risk scenarios.

A. Increased Risk of Miscarriage

• Fibroids in the first trimester can disrupt implantation and increase the risk of pregnancy loss.
• Placenta previa occurs when the placenta grows near or over a fibroid, restricting oxygen to the baby.

B. Preterm Labor and Fetal Growth Restriction

• Fibroid growth in the second trimester can lead to preterm labor due to uterine contractions.
• Fetal growth restriction happens when fibroids located near the placenta limit nutrients reaching the baby.

C. Severe Pain and Pregnancy Complications

• Fibroid symptoms include severe pain, especially in the third trimester, due to fibroid degeneration.
• Some pregnant women experience heavy bleeding or vaginal bleeding, leading to premature rupture of membranes.
• Postpartum hemorrhage is another concern, as fibroids in pregnancy can interfere with the uterus contracting properly after delivery.

3. Effects on Labor and Delivery

For many women, fibroids in pregnancy do not affect pregnancy outcomes. However, large fibroids or fibroids located near the birth canal can impact delivery.

Can You Have a Vaginal Delivery with Fibroids?

• If fibroids shrink or remain small, vaginal delivery is possible.
• Fibroids located near the cervix may block the birth canal, requiring a cesarean delivery.

What Are the Risks During Labor?

• Uterine rupture is rare but can occur if fibroids develop complications in the uterine wall.
• Placental abruption may happen if the placenta detaches prematurely due to fibroid growth.
• Preterm delivery is a possibility if uterine contractions start early.

Postpartum Recovery and Future Pregnancy

• Fibroids shrink after delivery due to hormone changes, but some may require a surgical procedure.
• Removing fibroids after pregnancy may improve fertility for those planning a future pregnancy.

A healthcare professional will monitor fibroids in pregnancy to ensure a healthy pregnancy and delivery.

Managing Uterine Fibroids During Pregnancy

For pregnant women with uterine fibroids, proper management is essential to prevent pregnancy complications like preterm labor, placental abruption, or fetal growth restriction. 

While some women with fibroids experience minimal symptoms, others may struggle with severe pain, heavy bleeding, or uterine contractions. 

The approach to managing fibroids in pregnancy focuses on pain relief, lifestyle changes, and regular prenatal care to ensure a healthy pregnancy. In some cases, interventional radiologists recommend uterine artery embolization—a non-surgical option to shrink fibroids and improve pregnancy outcomes in future pregnancies. Here’s how to manage fibroids effectively during pregnancy.

Pain Management for Uterine Fibroids Pregnancy

Pain from fibroids in pregnancy often worsens in the second trimester as fibroid growth stretches the uterus. Some fibroids located near the uterine wall can undergo degeneration, leading to severe pain and inflammation.

• Medication: Nonsteroidal anti-inflammatory drugs are sometimes prescribed but should only be taken under a doctor’s supervision.
• Hydration: Dehydration can trigger uterine contractions, worsening discomfort. Drinking enough water helps reduce fibroid symptoms.
• Rest: Avoiding prolonged standing and lying on the left side can improve blood supply to the uterus.

If fibroids develop complications, hospitalization may be required for IV fluids and pain management.

Safe Pregnancy Exercises and Lifestyle Adjustments

Light exercise can help pregnant women with fibroids stay active while reducing the risk of adverse pregnancy outcomes. However, intense workouts may worsen fibroid symptoms or increase the risk of preterm delivery.

Recommended Exercises:

• Prenatal yoga to ease pelvic pressure and enhance flexibility.
• Walking to improve circulation and support healthy pregnancy weight gain.
• Pelvic tilts to relieve lower back pain caused by large fibroids pressing on nerves.

Avoid high-impact exercises if fibroids located near the uterine cavity cause discomfort or heavy bleeding.

Dietary Adjustments to Reduce Inflammation

A nutrient-rich diet can help manage fibroids and lower inflammation, reducing the risk of placenta previa, pregnancy loss, or postpartum hemorrhage.

• Increase fiber intake to prevent bloating and improve digestion.
• Eat anti-inflammatory foods like leafy greens, nuts, and fish.
• Avoid processed foods that trigger hormonal imbalances and fibroid growth.

Maintaining a balanced diet helps ensure a steady blood supply to the uterus and supports fetal development.

Interventional Radiology – Uterine Artery Embolization as a Non-Surgical Option

For women planning a future pregnancy, interventional radiologists recommend uterine artery embolization (UAE) as an alternative to surgical procedures like laparoscopic myomectomy. UAE works by blocking the blood supply to fibroids, causing them to shrink.

• Ideal for women with fibroids who are not pregnant but wish to conceive later.
• Helps reduce fibroid size without affecting the uterine cavity or fallopian tubes.
• Lowers the risk of cesarean delivery by preventing fibroids from growing during pregnancy.

Unlike removing fibroids surgically, UAE is minimally invasive and offers a faster recovery.

Importance of Regular Prenatal Care

Frequent monitoring is essential for pregnant women with fibroids to prevent adverse pregnancy outcomes.

• Ultrasounds help track fibroid growth and assess risks like placental abruption or uterine rupture.
• Physical exams detect early signs of preterm labor or vaginal bleeding.
• Consulting a healthcare professional ensures early intervention for pregnancy complications.

Regular check-ups improve pregnancy outcomes and ensure the safest delivery method, whether vaginal delivery or cesarean delivery.

For those planning a future pregnancy, uterine artery embolization (UAE) is a highly effective non-surgical treatment. 

This procedure, performed by interventional radiologists, helps fibroids shrink by cutting off their blood supply, reducing the risk of pregnancy complications in the future. Unlike surgical procedures like laparoscopic myomectomy, UAE is minimally invasive and allows women to conceive later with fewer risks.

Medagg Healthcare – Your Trusted Partner in Fibroid Management

If you are looking for expert guidance on uterine fibroid pregnancy, Medagg Healthcare connects you with the best doctors, treatment options, and hospitals. Whether you need prenatal care, pain management strategies, or advanced fibroid treatment like uterine artery embolization, Medagg Healthcare ensures you receive personalized medical recommendations from top specialists.

Don’t wait—consult with the best experts today for a healthy pregnancy and better treatment outcomes.

Book an appointment

FAQs

1. Can fibroids cause pregnancy loss?
Yes, in some cases, fibroids located in the uterine cavity can interfere with implantation, increasing the risk of pregnancy loss, especially in early pregnancy.

2. Is normal delivery possible with fibroids?
It depends on the size and location of the fibroids. If they block the birth canal, a cesarean delivery may be required.

3. How do fibroids affect fetal growth?
Large fibroids near the placenta may lead to fetal growth restriction by limiting oxygen and nutrients to the baby.

4. Do fibroids always grow during pregnancy?
Not always. While some fibroids grow due to pregnancy hormones, others remain the same size or even shrink postpartum.

5. What is the best treatment for fibroids before pregnancy?
For women planning a future pregnancy, uterine artery embolization is a non-surgical option that helps fibroids shrink, improving fertility outcomes.