Uterine fibroids are non-cancerous growths that appear in the uterus. Commonly called Leiomyoma or Myoma fibroids. They are categorised in three ways:
- Submucosal – fibroids that grow into the uterine cavity.
- Intramural – fibroids that grow within the wall of the uterus.
- Subserosal – fibroids that grow on the outside of the uterus.
Depending on a fibroids size and shape or if they appear in a cluster, fibroids can put pressure on other organs such as the bladder, bowel and intestines. Fibroids can also push the uterus aside and force it to grow abnormally and change shape.
Uterine fibroids affect almost 50% of women of childbearing age. They can be as small as an apple seed or as big as a grapefruit, and in some cases can grow even larger. Fibroids do become more common as women age, particularly in the 30 – 40 year age group and through to menopause. Following menopause they usually shrink in size.
Fibroids are often linked with genetics and hormones, however researchers are still not completely certain what causes fibroids to grow. Unfortunately there is no known way to prevent fibroids from growing or reoccurring.
Symptoms of Fibroids
Most commonly, fibroids don’t have any symptoms and are usually diagnosed during pregnancy on ultrasound. However, some women have them diagnosed prior to pregnancy via pelvic examination, ultrasound or x-ray, usually because they have had some symptoms.
Common Symptoms of fibroids include:
- Heavy menstrual bleeding and painful periods
- Lower back pain
- Bloating in lower pelvic region
- Enlarged lower abdomen
- Frequency of urination
- Painful sex
Will Fibroids Affect my Pregnancy and Delivery
Most women with fibroids have will have a normal uncomplicated pregnancy and go on to have a normal vaginal delivery. The size and number of fibroids is noted during pregnancy and monitored via normal standard procedure ultrasound. We take a conservative approach to monitoring at regular antenatal visits. If pain develops, vaginal spotting or bleeding, or premature abdominal cramping you should seek medical advice immediately.
In some cases, fibroids can cause delivery complications, some of which would be known, antenatally and discussed during your regular visits.
Most common delivery complications for fibroids are:
- Due to size and location of the fibroid/s, a caesarean section may be required.
- Due to size and location a baby may be in breech or transverse position and caesarean is required.
- Due to size, position and growth of a fibroid in pregnancy, a labour can be delayed or not progress as it should.
- Multiple fibroids or a large fibroid can increase the risk of preterm birth.
- A large fibroid can grow into the area where the placenta is attached and may cause the placenta to break away from the wall of the uterus before delivery. (This is an emergency situation and the location of fibroid is usually known prior to delivery)
- Larger fibroids can increase the risk of heavy bleeding post delivery causing a post partum haemorrhage (greater than 500ml blood loss)
- Fibroids can also block the expulsion of the placenta and prevent the uterus from contracting effectively post delivery.
Women with noted uterine fibroids prior to labour, will be given an intravenous cannula on arrival to the delivery suite when in labour, so intravenous access can be gained following delivery.
A standard amount of intravenous Syntocinon is given prophylacticly to help the uterus to contract and avoid post delivery bleeding. This is a standard procedure across all hospitals.
If you have any questions about Uterine Fibroids, please ask us at your next visit.