Pregnancy and Fibroids: What Expectant Mothers Should Know

Pregnancy is often a time of excitement and anticipation, accompanied by months of careful planning for your baby's arrival. However, if you have been diagnosed with uterine fibroids or have just discovered them during a routine scan, it is natural to feel concerned about how they might affect your pregnancy.

Many first-time mothers with fibroids end up having questions about potential risks, symptoms and what to expect along the way. Understanding how fibroids interact with pregnancy can help you feel more prepared and reassured. With the right monitoring and guidance from your doctor, many concerns can be managed effectively, allowing you to focus on your health and your baby's development.

What Are Uterine Fibroids?

Uterine fibroids are non-cancerous growths that develop in or around the uterus. They are made up of muscle and fibrous tissue, and can vary widely in size, number and location. Some fibroids are too small to be noticed, while others can grow large enough to deform the shape of the uterus.

Fibroids are relatively common, especially among women of reproductive age. While the exact cause is not fully understood, their growth is often linked to hormonal factors such as oestrogen and progesterone.

There are several types of fibroids, classified based on where they are located:

• Intramural fibroids grow within the muscular wall of the uterus
• Subserosal fibroids develop on the outer surface of the uterus
• Submucosal fibroids grow just beneath the inner lining of the uterus

Many women with fibroids do not experience symptoms. However, depending on their size and position, fibroids can sometimes cause heavy menstrual bleeding, pelvic pressure or pain, and reproductive concerns.

Symptoms of Fibroids

Common symptoms of fibroids include:

• Pelvic pain or a feeling of pressure in the lower abdomen
• Frequent urination due to pressure on the bladder
• Lower back pain
• Abdominal bloating or a visible increase in abdominal size
• Pain during certain movements or activities

During pregnancy, some women may experience episodes of more intense pain, particularly if a fibroid outgrows its blood supply. This can lead to a condition known as fibroid degeneration, which may cause sudden and localised abdominal pain.

How Can Fibroids Affect Pregnancy?

Fibroids can cause a range of symptoms that may become more noticeable during pregnancy, especially as the uterus expands and places additional pressure on surrounding organs. Recognising these symptoms early can help you seek timely medical advice and avoid unnecessary complications.

Possible ways fibroids can affect pregnancy include:

Pain and Discomfort

Fibroids may increase in size during pregnancy due to hormonal changes, which can lead to episodes of pain or a constant feeling of discomfort. This is often more noticeable in the second and third trimesters.

In some cases, the pain may be severe enough to interfere with daily activities or rest. This can affect overall well-being, and expectant mothers may require medical support to manage symptoms safely during pregnancy.

Placental Complications

Fibroids can affect how and where the placenta attaches within the uterus. This may increase the risk of conditions such as placenta previa or placental abruption, both of which can impact the pregnancy.

These complications may lead to bleeding, reduced oxygen supply to the baby or the need for early delivery. Careful monitoring through scans is important to assess placental position and function throughout pregnancy.

Preterm Labour

The presence of fibroids may increase the likelihood of preterm labour, where contractions begin before the pregnancy reaches full term. This can be linked to reduced space within the uterus or irritation caused by the fibroids.

Preterm labour can lead to premature birth, which may cause the baby to require specialised care after delivery. Early detection and monitoring can help manage risks and support better outcomes.

Foetal Positioning Issues

Fibroids can take up space within the uterus, which may affect how the baby is positioned as the pregnancy progresses. This can result in suboptimal positions that may make vaginal delivery more challenging and increase the likelihood of requiring a caesarean section.

Risk of Miscarriage

Certain fibroids, especially those that distort the uterine cavity, may interfere with the implantation or growth of the pregnancy. This can increase the risk of miscarriage, particularly in the early stages.

The extent of this risk depends on factors such as the fibroid's size and exact location. Women with known fibroids may require closer monitoring in early pregnancy to ensure the baby is developing normally.

With regular monitoring and appropriate care, many of these risks can be managed effectively. Your doctor will assess your individual situation and guide you on the best way to support a safe and healthy pregnancy.

How Are Fibroids Managed?

In most cases, fibroids are not surgically removed during pregnancy. This is because removal procedures may carry a risk of heavy bleeding, increasing the chances of complications for both the mother and baby. Instead, management during pregnancy is usually focused on monitoring and symptom control.

Active Fibroid Monitoring

Regular fibroid monitoring is important to ensure that any potential complications are identified early. This monitoring is done through routine ultrasound scans to assess their size, location and any changes over time. Your doctor will also check how the fibroids may be affecting the baby's growth or the position of the placenta.

Pain Relief and Symptom Management

If fibroids cause pain or discomfort, your doctor may recommend safe pain relief options that are suitable during pregnancy. Rest, hydration and avoiding activities that trigger discomfort may also help manage symptoms.

In cases of fibroid degeneration, short-term medical management may be required to control pain. Hospital observation may be recommended if symptoms are severe or need closer monitoring.

When Should You See a Doctor for Fibroids?

If you are pregnant or planning to conceive, it is important to see a doctor if you have known fibroids or symptoms such as persistent pelvic pain, a feeling of pressure in the lower abdomen or unusual discomfort. Assessing fibroids before pregnancy allows your doctor to determine whether they could affect conception or lead to complications such as miscarriage or preterm labour.

In certain cases, pre-emptive treatment is able to remove or reduce fibroids before pregnancy, helping to create a safer environment for the baby to develop. Even when treatment is not necessary, knowing the status of your fibroids allows for closer monitoring and better planning throughout your pregnancy.

Supporting a Healthy Pregnancy With Specialist Care

With timely medical guidance and appropriate care, many women are able to experience a healthy pregnancy term despite the presence of uterine fibroids. Early assessment, regular monitoring and a personalised care plan can make a meaningful difference in managing symptoms and reducing potential risks throughout your pregnancy.

At The Wei-Wei Clinic for Women, care is centred on clear communication, evidence-based treatment and thoughtful guidance tailored to your needs. Dr Wei-Wei Wee-Stekly, senior consultant obstetrician and gynaecologist, provides careful evaluation and ongoing support for patients with fibroids and other conditions, helping them to make informed decisions at every stage.

If you have fibroids and are pregnant or planning for pregnancy, seeking timely medical advice can help you move forward with greater clarity and confidence. Contact us today to arrange a consultation and receive guidance tailored to your individual pregnancy journey.