Many women of childbearing age get affected by uterine fibroids, which can be as small as a pea or as big as a grapefruit. They tend to become common as women cross the age of 30. Even though fibroids are non-cancerous, expecting moms have many questions related to fibroids and pregnancy. Some may wonder if they can have a normal vaginal delivery with fibroids or a caesarean section is necessary.

What are fibroids?

Fibroids are non-cancerous muscular growths that develop within the uterine wall. They commonly appear as single tumours, but can manifest in multiple forms within the uterus. While most fibroids remain small, in rare instances, they can grow to substantial sizes, says Obstetrician and Gynaecologist Dr Nandita Palshetkar.

What are the symptoms of fibroids?

While not all women with fibroids experience symptoms, these benign growths in the uterus can lead to various issues for some individuals. Symptoms of fibroids may include heavy menstrual bleeding resulting in:

• Anaemia
• Painful periods
• A sense of pelvic fullness
• Pressure in the lower stomach region
• An enlargement of the lower abdomen
• Frequent urination
• Pain during sex
• Lower back discomfort

What are the causes of fibroids?

Several factors can influence the likelihood of developing fibroids. They tend to become more prevalent as women age, particularly during their 30s and 40s and often diminish after menopause, says Dr Palshetkar.

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Other causes include:

• A family history of fibroids.
• Obesity.
• Eating a diet rich in red meat and ham correlates with a higher likelihood of fibroids.

Can treatment for fibroids be done during pregnancy?

In many cases, fibroids during pregnancy may not necessitate treatment. However, if symptoms like pain or discomfort arise, a doctor might recommend rest as a primary measure. In more severe instances where symptoms such as pain, bleeding or the possibility of preterm labour occur, hospitalisation might be necessary for pregnant women with fibroids. Although exceptionally rare, there are instances where myomectomy, which is the surgical removal of fibroids, might be considered during pregnancy. Fortunately, in most cases, fibroids tend to decrease in size post-pregnancy, says Dr Palshetkar.

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Can women have a vaginal delivery with fibroids?

Pregnant women with fibroids can have a vaginal delivery, but the presence of fibroids may lead to various complications and increase the likelihood of a caesarean section, says Obstetrician and Gynaecologist Dr Varini N. There is a high chance that fibroids can block the child’s route from the mom’s abdomen and through her vagina for delivery, requiring a c-section.

What are the complications during childbirth for women with fibroids?

While many women with fibroids have uncomplicated pregnancies, some may experience challenges during childbirth due to the presence of these growths.

Here are some of the complications:

1. Malpresentation

Large fibroids or those located near the cervix can obstruct the baby’s passage through the birth canal, leading to malpresentation (when the baby is not facing head-first down the birth canal).

2. Placental abruption

Fibroids may increase the risk of placental abruption, where the placenta separates from the uterine wall before delivery, says Dr Varini.

3. Preterm birth

The presence of fibroids can be associated with an increased risk of preterm birth, which means that the baby arrives before the 37th week of pregnancy.

Other potential complications are:

• In rare cases, fibroids can lead to uterine rupture during labour.
• Fibroids may cause prolonged or obstructed labour.

Make sure you attend all prenatal appointments to monitor the growth of the fibroids and the baby. Regular monitoring will allow your doctor to assess potential complications. Fibroids can grow in pregnancy and can undergo degeneration causing severe pain. So, don’t neglect any abdominal pain during pregnancy and take help of your doctor.