What are uterine fibroids?
The term uterine fibroids refers to leiomyomas or simply myomas, which are benign tumors that can form in the smooth muscle of the wall of the uterus. Leiomyomas can exist before, during, or after pregnancy and while they are not cancerous, they can cause problems because they occupy space in the uterus and interfere with its normal ability to stretch evenly during pregnancy.
How common are uterine fibroids in pregnancy?
Uterine fibroids are the most common pelvic tumors and the most common benign tumors in women. Approximately 60 percent of women of reproductive age, and 80 percent of women in the course of their lifetimes develop uterine fibroids. Uterine fibroids have been reported as present in roughly 11 percent of pregnancies, although the number is probably higher because only fairly large fibroids produce symptoms.
How are uterine fibroids diagnosed?
Your doctor can have a strong hint that you may have uterine fibroids based on your reporting of uterine bleeding, especially heavy bleeding during your menstrual cycle, combined with findings on a routine pelvic exam. Blood tests also will be performed to test for hormones and evidence of blood loss. Once this is done, the presence of uterine fibroids can be confirmed by several techniques including hysteroscopy, magnetic resonance imaging (MRI), hysterosonography, and hysterosalpingography.
Do uterine fibroids cause problems during pregnancy?
Generally, uterine fibroids do not cause major problems during pregnancy and its only when the fibroids grow fairly large that they cause problems whether you are pregnant or not. However, the risk of spontaneous abortion (miscarriage) and preterm delivery increase slightly.
Do uterine fibroids during pregnancy cause problems for the baby?
Generally, uterine fibroids do not cause problems for the baby. However, the risks increase slightly for spontaneous abortion (miscarriage), and for preterm delivery, which can lead to some physical problems during infancy and behavioral problems during childhood.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the uterine fibroids
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat uterine fibroids during pregnancy?
Medications to treat uterine fibroids generally are given outside of pregnancy. These are hormonal treatments, which include gonadotropin-releasing hormone (Gn-RH) agonists, which block the production of estrogen and progesterone as if you were post-menopausal. Oral contraceptives may be prescribed, or a device can be implanted that releases the hormone progestin. Non-hormonal treatments include tranexamic acid, which is taken only on heavy bleeding days to ease menstrual periods, and nonsteroidal anti-inflammatory drugs (NSAIDs) which include ibuprofen, naproxen, and many others. Oral contraceptives must be avoided during pregnancy. NSAIDs should be avoided during the late part of pregnancy.
Who should NOT stop taking medication for uterine fibroids in pregnancy?
Generally, the available medications for uterine fibroids are given only to non-pregnant patients.
What should I know about choosing a medication for uterine fibroids in pregnancy?
You may find Pregistrys expert reports about the individual medications to treat uterine fibroids here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for uterine fibroids when I am breastfeeding?
NSAIDs are thought to be relatively safe in mothers who breastfeed. Hormonal treatments for uterine fibroids are likely to be safe, as breast milk is full of the mother’s hormones anyway.
What alternative therapies besides medications are there to treat uterine fibroids during pregnancy?
Watchful waiting is the standard treatment, since most uterine fibroids are small and produce no symptoms, and since fibroids can come and go over time. Various surgical procedures are available to destroy uterine fibroids. These include removing them (myomectomy), destroying them with heat (ablation), electric current or microwave energy, destruction by low temperature or by radiofrequency, or intentional production of clots in the arteries that feed the fibroids (uterine artery embolization).
What can I do for myself and my baby when I have uterine fibroids during pregnancy?
Reassure yourself that most pregnancies proceed normally in the presence of uterine fibroids. In severe cases, work with your physicians and be open to the various treatment options, most of which would be implemented after your pregnancy is complete.
Resources for uterine fibroids during pregnancy:
For more information about uterine fibroids during pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles: