Uterine fibroids and pregnancy: what impact?
Very common in women of childbearing age, uterine fibroids do not usually pose problems before pregnancy or even during its unfolding. Depending on their size and exact position, some of them may require treatment.
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- Uterine fibroids are benign tumors, formed from the muscle cells of the uterus. They appear from the age of 30: the exact process leading to their formation remains rather mysterious.
- According to their positioning, three main types are distinguished, including intramural or interstitial fibroids, which are by far the most common, since they account for about 70% of cases. They develop in the heart of the uterine muscle and usually do not brake to get pregnant. Surgery may, however, be proposed when the intramural fibroids are large enough to interfere with the nesting of the egg in the uterine wall, but this is very rarely necessary.
- Usually, these fibroids also do not matter during pregnancy itself. Some of them, however, grow in size because of the increase in estrogen levels, which can cause pain or even other unpleasant ailments such as constipation. In such cases, the doctor may prescribe medication to relieve the symptoms.
- Like intramural fibroids, sub-serous fibroids are asymptomatic. These fibroids grow on the outer wall of the uterus: sometimes they are connected by a narrow pedicle (pediculate fibroids). In other cases, their “base” is much broader: they are called sessile fibroids.
- Usually, sub-serous fibroids do not require any treatment because they do not interfere with the implantation of the egg or the proper course of the pregnancy.
- Note: this is very rare, but a pediculate sub-serous fibroid may increase the risk of premature delivery in case of torsion and then necrosis of the pedicle. However, medical treatment (rest and medication) may be sufficient to correct the problem. The surgical treatments are exceptional.
- Endocavitary fibroids, also known as submucosal fibroids, are the rarest uterine fibroids. They form just under the lining of the uterine cavity (wall lining the inside of the uterus).
- These fibroids are usually the most troublesome, on the one hand, because they can prevent the implantation of the egg, on the other hand, because they can cause heavy bleeding (menstruation larger than normal, followed by Bleeding outside the menstrual period). The resulting blood loss can lead to anemia, which is best corrected before getting pregnant.
- For these reasons, endocavitary fibroids are often surgically removed in women considering pregnancy
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