Fibroids, also known as leiomyomas and myomas are noncancerous benign tumors made up of smooth muscle cells and fibrous connective tissue. They grow in the woman's womb during her childbearing years. The size of a fibroid can vary from the size of a bean to as large as a melon.
Generally speaking, it is uncommon for fibroids to cause severe health consequences. According to researches, the most common complication of fibroids during pregnancy is a pain. Fibroids may also increase the risk for other complications during pregnancy as well as delivery. These include:
● Fetal growth restriction: Large fibroids may prevent a fetus from growing completely due to a lack of sufficient space in the womb.
● Placental abruption: This interruption in the placenta occurs when the placenta breaks away from the fibroid due to blockage by a fibroid. This reduces the flow of vital oxygen and nutrients to the fetus.
● Cesarean delivery: Researches estimate that women with fibroids have a high probability of a C-section or a cesarean delivery than women who don't have these growths.
● Preterm delivery: Pain from fibroids may lead to uterine contraction and hence a premature delivery.
● Breech position: Due to the abnormal shape of the cavity, the baby may not be able to align for vaginal delivery.
● Miscarriage: The women with high fibroid growth have a major risk of miscarriage.
● Bleeding and pain: The presence of fibroid in the wound causes bleeding and pain during the first trimester. Heavy bleeding can lead to dangerous anemia.
In rare cases, large fibroids can press on the bladder and ureter leading to kidney problems. Other complications may include infertility and recurrent pregnancy loss.
The growth of fibroids mostly occurs in the first trimester of pregnancy due to the presence of a hormone called estrogen. While estrogen levels are high, especially during pregnancy, fibroids tend to swell. These are most likely to develop when a woman is taking birth control pills that contain estrogen. Besides, genetic factors also impact the development of fibroids.
In the pregnancy phase, the treatment of uterine fibroids is limited because of the high risk of complications to the fetus. Over-the-counter mild medicines and pain relievers may be recommended to the expectant mothers for relief. Taking bed rest and drinking plenty of water is advised.
In an extreme scenario, myomectomy, a type of surgery is advised by the doctor for removal of fibroids either from outside of the uterus or from within the urine wall while leaving the uterus intact.
Fibroids originate from the muscle layers of the womb and usually develop in women between 16 to 50 years of age. These are the reproductive years during which estrogen levels are higher.
On average, every third woman experiences the following symptoms of fibroid formation in their body:
● Menorrhagia or heavy and painful periods
● Anemia from heavy periods
● Lower backache or pain in legs
● Constipation
● Frequent urination
● Discomfort in the lower abdomen especially where there are large fibroids
● Dyspareunia or pain during intercourse
● Pregnancy-related problems like bleeding, pain
● Fertility problems
● Labor problems
● Repeated miscarriages
● Weight gain and swelling in the lower abdomen
In general, fibroids need no ailment. Treatment is only advised if the symptoms are severe. At first place, your doctor will recommend your treatment through medication which may include:
● GnRH drug
● Nonsteroidal anti-inflammatory drugs
● Birth control pills
● Levonorgestrel intrauterine system(LNGIUS)
Surgery may be recommended in case severe fibroids do not respond to more conservative treatment options. Depending on the severity, either of the following procedures is adopted:
● Hysterectomy: This procedure involves partial or total womb removal in case of very large fibroids or excessive bleeding. If a surgeon removes ovaries and fallopian tubes, side effects may include reduced libido and early menopause.
● Myomectomy: It implies the removal of fibroids from the muscular wall of the womb. This type of surgery is not beneficial in case a woman has large fibroids or if the fibroids are located in particular parts of the womb.
● Endometrial ablation: It removes the lining inside the womb and may help if fibroids are near the inner surface of the womb.
● Uterine fibroid embolization: With the help of fluoroscopic X-ray imaging, a chemical is injected through a catheter to cut off blood supply into the arteries. This shrinks the fibroids.
● MRI-guided focused ultrasound surgery: MRI scan locates the fibroids and high energy ultrasound waves are delivered to shrink them.
● MRI-guided percutaneous laser ablation: Using MRI scan, fibroids are located. Thereafter, laser fiber devices using fine needles are inserted through the skin to reach the targeted fibroids. The laser light shrinks the fibroids.