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Fibroids, also known as uterine leiomyomas, are benign (non-cancerous) growths in the uterus. While they are common and often don’t cause symptoms, they can sometimes impact pregnancy. The effect of fibroids on pregnancy depends on their size, number, and location. Here’s how fibroids can affect pregnancy:

1. Difficulty Conceiving (Infertility)

  • Interference with Implantation: Fibroids located inside the uterine cavity (submucosal fibroids) can distort the shape of the uterus, making it difficult for a fertilized egg to implant properly.
  • Blockage of Fallopian Tubes: Large fibroids can press on the fallopian tubes, preventing sperm from reaching the egg or blocking the passage of the fertilized egg to the uterus.

2. Increased Risk of Miscarriage

  • Distortion of the Uterine Cavity: Submucosal fibroids, which grow inside the uterus, can affect the lining and cause miscarriages by preventing the embryo from developing normally.
  • Poor Blood Supply: Fibroids can alter blood flow to the placenta, limiting the oxygen and nutrients available to the developing fetus, which may lead to miscarriage or poor fetal growth.

3. Preterm Labor and Birth

  • Uterine Contractions: Large fibroids can cause the uterus to contract irregularly, increasing the risk of preterm labor.
  • Space Occupied by Fibroids: If fibroids are large, they can take up space in the uterus, restricting the baby’s growth or causing preterm labor due to pressure on the cervix.

4. Placental Problems

  • Placental Abruption: Fibroids can increase the risk of placental abruption, a condition where the placenta detaches from the uterus prematurely, causing bleeding and restricting the baby’s oxygen and nutrient supply.
  • Placenta Previa: The presence of fibroids can sometimes lead to the placenta attaching abnormally low in the uterus, potentially causing placenta previa, which increases the risk of complications during delivery.

5. Breech Position

  • Abnormal Fetal Position: If fibroids are large or numerous, they can prevent the baby from moving into a head-down position, which is optimal for vaginal delivery. This may result in a breech presentation, requiring a C-section.

6. Cesarean Section (C-Section)

  • Obstruction During Labor: If fibroids are large, especially those located near the cervix (lower part of the uterus), they can obstruct the birth canal, making a vaginal delivery difficult or impossible. This can increase the likelihood of needing a C-section.

7. Postpartum Hemorrhage

  • Bleeding After Delivery: After childbirth, the uterus typically contracts to stop bleeding. Fibroids can interfere with this process, leading to a higher risk of postpartum hemorrhage.

8. Intrauterine Growth Restriction (IUGR)

  • Restricted Fetal Growth: Large fibroids can restrict the space available for the baby to grow, potentially leading to IUGR, where the baby is smaller than expected for the gestational age.

9. Pain and Discomfort

  • Growth of Fibroids: Fibroids often grow during pregnancy due to increased estrogen levels, which can cause discomfort, pelvic pain, and pressure on nearby organs like the bladder or bowels.
  • Degeneration of Fibroids: Occasionally, fibroids outgrow their blood supply, leading to degeneration. This can cause severe pain, especially during the second and third trimesters.

10. Complications with Labor

  • Prolonged Labor: Fibroids can sometimes cause labor to take longer because they interfere with the normal contractions of the uterus, increasing the likelihood of an assisted delivery or C-section.

Managing Fibroids During Pregnancy

If fibroids are detected before or during pregnancy, your healthcare provider will monitor their growth and any potential complications. While many women with fibroids have healthy pregnancies, those with large or symptomatic fibroids may require additional care.

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