How to get rid of fibroids during pregnancy

Fibroids, which are also known as leiomyomas, are non-cancerous tumors, or growths, that appear on the walls of the uterus. It’s unknown why they occur, but fibroids affect at least 20 percent of all women during their lifetime, with occurrence numbers as high as 80 percent.

Fibroids are made up of the same smooth muscle fibers found in the uterine wall (myometrium), but are denser than normal myometrium. They are usually round and have no predictable growth pattern. Some are small like a seed while others can grow as large as a small melon, causing considerable discomfort. Some fibroids can increase the size of the uterus to the point that it reaches the rib cage. Fibroids are growths, but are not indicative of an increased risk of cancer. Occasionally malignant growths on the muscles inside the womb, called leiomyosarcoma, can develop.

Fibroids typically appear before pregnancy, but most women aren’t aware they have them until they’re discovered during an exam or ultrasound. Symptoms of fibroids during pregnancy include:

  • Abdominal pain
  • Pelvic pressure
  • Unusually heavy vaginal bleeding
  • Constipation
  • Frequent urination

If you suffer from any of these symptoms, it’s important you let your physician know as soon as possible.

The majority of women who have fibroids during pregnancy don’t have complications. But an estimated 10 to 30 percent of pregnant women with fibroids may struggle with symptoms. While fibroids are unlikely to affect the baby, the risk of miscarriage or early delivery is slightly higher with fibroids. If the fibroids are particularly large, they can alter how the baby is positioned for delivery or obstruct the birthing process, which increases the need to have a cesarean delivery.

The most common problems for women with fibroids are:

  • Breech baby – As noted, if the baby is not positioned correctly for vaginal delivery, complications could ensue.
  • Cesarean section – Women with fibroids are five times more likely to give birth through C-section.
  • Early delivery – Fibroids can hasten delivery.
  • Slow Labor – Women with fibroids may have a longer, more painful delivery period.
  • Placental abruption – This is when the placenta breaks away from the wall of the uterus before delivery. The risk of this happening is that the fetus may not get enough oxygen.

Because of an increase in hormones during pregnancy, fibroids can grow larger during that time. Alternatively, cases exist where fibroids have also shrunk. You doctor will best be able to guide you on the proper treatment. The most common treatment option is bed rest. If necessary, you may require some form of medication.

Another treatment option is Uterine Fibroid Embolization (UFE), which is a non-surgical, minimally invasive treatment performed by an Interventional Radiologist that shrinks the fibroids to provide relief. With UFE, a thin tube is inserted into the blood vessels that supply blood to the fibroid. Compounds are injected into the blood vessels, blocking the blood supply to the fibroid and causing it to shrink.

UFE is 90 percent effective in reducing symptoms caused by fibroids. The Interventional Radiologists of Interventional Physicians of Indiana perform this procedure at Community Hospitals North and East.

  • Uterine Fibroids Overview
  • Symptoms
  • Diagnosis
  • Treatments
  • Surgery

Medically Reviewed by Nivin Todd, MD on November 08, 2020

Fibroids are tumors that grow from muscle tissue in the uterus. They are not cancerous. They can be as small as a pea or larger than a grapefruit. They can grow outside the uterine wall, inside the uterine cavity, or within the uterine wall. Many women have multiple fibroids of different sizes.

An estimated 40% to 60% of women have fibroids by age 35. Up to 80% of women have them by age 50. But detecting them during pregnancy isn’t always easy. That’s because it’s hard for doctors to tell fibroids from the thickening of uterus muscles that occurs during pregnancy. For this reason, doctors think the number of known cases is lower than the real number.

Most women who have been diagnosed with fibroids go on to have normal pregnancies, but sometimes they can cause challenges.

Most fibroids don’t grow while you’re pregnant, but if it happens it most likely will be during your first 3 months (first trimester). That’s because fibroids need a hormone called estrogen to grow. Your body produces more of it when you’re pregnant.

The primary problems that could occur are:

  • Bleeding and pain. In a study of more than 4,500 women, researchers found that 11% of the women who had fibroids also had bleeding, and 59% had just pain. But 30% of the women had both bleeding and pain during their first trimester.
  • Miscarriage. Women with fibroids are much more likely to miscarry during early pregnancy than women without them (14% vs. 7.6%). And if you have multiple or very larg fibroids, your chances go up even more.

As your uterus expands to make room for your baby, it can push against your fibroids. This can cause a number of issues during your pregnancy:

  • Pain. This is the most common symptom of fibroids, especially if they’re large. Sometimes, fibroids twist, which can cause cramping and discomfort. Other times, the fibroid outgrows its blood supply, turns red and dies. This process, called “red degeneration,” can cause severe stomach pains. In some cases, it can lead to miscarriage. Over-the-counter medicines like acetaminophen (Tylenol) can ease your pain. But avoid ibuprofen (Advil) early in your pregnancy because it may cause problems with gestation and also in your third trimester. It could cause you to miscarry, reduce the amount of amniotic fluid or cause hearts problems in your baby.
  • Placental abruption. Ongoing studies seem to show that pregnant women with fibroids have a much greater chance of placental abruption than women without fibroids. That means your placenta tears away from the wall of your uterus before your baby is delivered. It’s very serious because your baby won’t get enough oxygen and you can have heavy bleeding. You could go into shock.
  • Preterm delivery. If you have fibroids, you’re more likely to deliver preterm -- meaning your baby is born before 37 weeks of pregnancy -- than women without fibroids.

Many studies show that having uterine fibroids increase your odds of having a cesarean section. That could be because the fibroids can keep the uterus from contracting and they can also block your birth canal, slowing down the progress of your labor. Women who have fibroids are six times more likely than other women to need a C-section.

Breech birth is another potential problem. In a normal birth, the baby comes out the birth canal head first. In a breech birth, the baby’s butt or feet come out first.

Fibroids often shrink after pregnancy. In one study, researchers found that, 3 to 6 months after delivery, 70% of women who had live births saw their fibroids shrink more than 50%.

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1. Day Baird D, Dunson DB, Hill MC, et al. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188:100–107. [PubMed] [Google Scholar]

2. Muram D, Gillieson M, Walters JH. Myomas of the uterus in pregnancy: ultrasonographic follow-up. Am J Obstet Gynecol. 1980;138:16–19. [PubMed] [Google Scholar]

3. Burton CA, Grimes DA, March CM. Surgical management of leiomyomata during pregnancy. Obstet Gynecol. 1989;74:707–709. [PubMed] [Google Scholar]

4. Rice JP, Kay HH, Mahony BS. The clinical significance of uterine leiomyomas in pregnancy. Am J Obstet Gynecol. 1989;160:1212–1216. [PubMed] [Google Scholar]

5. Qidwai GI, Caughey AB, Jacoby AF. Obstetric outcomes in women with sonographically identified uterine leiomyomata. Obstet Gynecol. 2006;107:376–382. [PubMed] [Google Scholar]

6. Cooper NP, Okolo S. Fibroids in pregnancycommon but poorly understood. Obstet Gynecol Surv. 2005;60:132–138. [PubMed] [Google Scholar]

7. Klatsky PC, Tran ND, Caughey AB, Fujimoto VY. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstet Gynecol. 2008;198:357–366. [PubMed] [Google Scholar]

8. Aharoni A, Reiter A, Golan D, et al. Patterns of growth of uterine leiomyomas during pregnancy. A prospective longitudinal study. Br J Obstet Gynaecol. 1988;95:510–513. [PubMed] [Google Scholar]

9. Rosati P, Exacoustòs C, Mancuso S. Longitudinal evaluation of uterine myoma growth during pregnancy. A sonographic study. J Ultrasound Med. 1992;11:511–515. [PubMed] [Google Scholar]

10. Lev-Toaff AS, Coleman BG, Arger PH, et al. Leiomyomas in pregnancy: sonographic study. Radiology. 1987;164:375–380. [PubMed] [Google Scholar]

11. Katz VL, Dotters DJ, Droegemueller W. Complications of uterine leiomyomas in pregnancy. Obstet Gynecol. 1989;73:593–596. [PubMed] [Google Scholar]

12. De Carolis S, Fatigante G, Ferrazzani S, et al. Uterine myomectomy in pregnant women. Fetal Diagn Ther. 2001;16:116–119. [PubMed] [Google Scholar]

13. Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007;87:725–736. [PubMed] [Google Scholar]

14. Benson CB, Chow JS, Chang-Lee W, et al. Outcome of pregnancies in women with uterine leiomyomas identified by sonography in the first trimester. J Clin Ultrasound. 2001;29:261–264. [PubMed] [Google Scholar]

15. Goldenberg M, Sivan E, Sharabi Z, et al. Outcome of hysteroscopic resection of submucous myomas for infertility. Fertil Steril. 1995;64:714–716. [PubMed] [Google Scholar]

16. Casini ML, Rossi F, Agostini R, Unfer V. Effects of the position of fibroids on fertility. Gynecol Endocrinol. 2006;22:106–109. [PubMed] [Google Scholar]

17. Bernard G, Darai E, Poncelet C, et al. Fertility after hysteroscopic myomectomy: effect of intramural myomas associated. Eur J Obstet Gynecol Reprod Biol. 2000;88:85–90. [PubMed] [Google Scholar]

18. Wallach EE, Vu KK. Myomata uteri and infertility. Obstet Gynecol Clin North Am. 1995;22:791–799. [PubMed] [Google Scholar]

19. Winer-Muram HT, Muram D, Gillieson MS. Uterine myomas in pregnancy. J Can Assoc Radiol. 1984;35:168–170. [PubMed] [Google Scholar]

20. Exacoustòs C, Rosati P. Ultrasound diagnosis of uterine myomas and complications in pregnancy. Obstet Gynecol. 1993;82:97–101. [PubMed] [Google Scholar]

21. Vergani P, Locatelli A, Ghidini A, et al. Large uterine leiomyomata and risk of cesarean delivery. Obstet Gynecol. 2007;109:410–414. [PubMed] [Google Scholar]

22. Coronado GD, Marshall LM, Schwartz SM. Complications in pregnancy, labor, and delivery with uterine leiomyomas: a population-based study. Obstet Gynecol. 2000;95:764–769. [PubMed] [Google Scholar]

23. Chuang J, Tsai HW, Hwang JL. Fetal compression syndrome caused by myoma in pregnancy: a case report. Acta Obstet Gynecol Scand. 2001;80:472–473. [PubMed] [Google Scholar]

24. Graham JM , Jr, Miller ME, Stephan MJ, Smith DW. Limb reduction anomalies and early in utero limb compression. J Pediatr. 1980;96:1052–1056. [PubMed] [Google Scholar]

25. Romero R, Chervenak FA, DeVore G, et al. Fetal head deformation and congenital torticollis associated with a uterine tumor. Am J Obstet Gynecol. 1981;141:839–840. [PubMed] [Google Scholar]

26. Phelan JP. Myomas and pregnancy. Obstet Gynecol Clin North Am. 1995;22:801–805. [PubMed] [Google Scholar]

27. Vergani P, Ghidini A, Strobelt N, et al. Do uterine leiomyomas influence pregnancy outcome? Am J Perinatol. 1994;11:356–358. [PubMed] [Google Scholar]

28. Aydeniz B, Wallwiener D, Kocer C, et al. Significance of myoma-induced complications in pregnancy. A comparative analysis of pregnancy course with and without myoma involvement [Article in German] Z Geburtshilfe Neonatol. 1998;202:154–158. [PubMed] [Google Scholar]

29. Donnez J, Pirard C, Smets M, et al. Unusual growth of a myoma during pregnancy. Fertil Steril. 2002;78:632–633. [PubMed] [Google Scholar]

30. Roberts WE, Fulp KS, Morrison JC, Martin JN., Jr The impact of leiomyomas on pregnancy. Aust N Z J Obstet Gynaecol. 1999;39:43–47. [PubMed] [Google Scholar]

31. Hasan F, Arumugam K, Sivanesaratnam V. Uterine leiomyomata in pregnancy. Int J Gynaecol Obstet. 1991;34:45–48. [PubMed] [Google Scholar]

32. Ohkuchi A, Onagawa T, Usui R, et al. Effect of maternal age on blood loss during parturition: a retrospective multivariate analysis of 10,053 cases. J Perinat Med. 2003;31:209–215. [PubMed] [Google Scholar]

33. Szamatowicz J, Laudanski T, Bulkszas B, Akerlund M. Fibromyomas and uterine contractions. Acta Obstet Gynecol Scand. 1997;76:973–976. [PubMed] [Google Scholar]

34. Palerme GR, Friedman EA. Rupture of the gravid uterus in the third trimester. Am J Obstet Gynecol. 1966;94:571–576. [PubMed] [Google Scholar]

35. Miller CE. Myomectomy. Comparison of open and laparoscopic techniques. Obstet Gynecol Clin North Am. 2000;27:407–420. [PubMed] [Google Scholar]

36. Brown AB, Chamberlain R, Te Linde RW. Myomectomy. Am J Obstet Gynecol. 1956;71:759–763. [PubMed] [Google Scholar]

37. Levine D, Hulka CA, Ludmir J, et al. Placenta accreta: evaluation with color Doppler US, power Doppler US, and MR imaging. Radiology. 1997;205:773–776. [PubMed] [Google Scholar]

38. Harris WJ. Uterine dehiscence following laparoscopic myomectomy. Obstet Gynecol. 1992;80:545–546. [PubMed] [Google Scholar]

39. Dubuisson JB, Chavet X, Chapron C, et al. Uterine rupture during pregnancy after laparoscopic myomectomy. Hum Reprod. 1995;10:1475–1477. [PubMed] [Google Scholar]

40. Dubuisson JB, Fauconnier A, Deffarges JV, et al. Pregnancy outcome and deliveries following laparoscopic myomectomy. Hum Reprod. 2000;15:869–873. [PubMed] [Google Scholar]

41. Dubuisson JB, Fauconnier A, Babaki-Fard K, Chapron C. Laparoscopic myomectomy: a current view. Hum Reprod Update. 2000;6:588–594. [PubMed] [Google Scholar]

42. Asakura H, Oda T, Tsunoda Y, et al. A case report: change in fetal heart rate pattern on spontaneous uterine rupture at 35 weeks gestation after laparoscopically assisted myomectomy. J Nippon Med Sch. 2004;71:69–72. [PubMed] [Google Scholar]

43. Lieng M, Istre O, Langebrekke A. Uterine rupture after laparoscopic myomectomy. J Am Assoc Gynecol Laparosc. 2004;11:92–93. [PubMed] [Google Scholar]

44. Banas T, Klimek M, Fugiel A, Skotniczny K. Spontaneous uterine rupture at 35 weeks’ gestation, 3 years after laparoscopic myomectomy, without signs of fetal distress. J Obstet Gynaecol Res. 2005;31:527–530. [PubMed] [Google Scholar]

45. Grande N, Catalano GF, Ferrari S, Marana R. Spontaneous uterine rupture at 27 weeks of pregnancy after laparoscopic myomectomy. J Minim Invasive Gynecol. 2005;12:301. [PubMed] [Google Scholar]

46. Norton ME, Merril J, Cooper BA, et al. Neonatal complications after administration of indomethacin for preterm labor. N Engl J Med. 1993;329:1602–1607. [PubMed] [Google Scholar]

47. Seki H, Takizawa Y, Sodemoto T. Epidural analgesia for painful myomas refractory to medical therapy during pregnancy. Int J Gynaecol Obstet. 2003;83:303–304. [PubMed] [Google Scholar]

48. Wittich AC, Salminen ER, Yancey MK, Markenson GR. Myomectomy during early pregnancy. Mil Med. 2000;165:162–164. [PubMed] [Google Scholar]

49. Li TC, Mortimer R, Cooke ID. Myomectomy: a retrospective study to examine reproductive performance before and after surgery. Hum Reprod. 1999;14:1735–1740. [PubMed] [Google Scholar]

50. Surrey ES, Minjarez DA, Stevens JM, Schoolcraft WB. Effect of myomectomy on the outcome of assisted reproductive technologies. Fertil Steril. 2005;83:1473–1479. [PubMed] [Google Scholar]

51. Glavind K, Palvio DH, Lauritsen JG. Uterine myoma in pregnancy. Acta Obstet Gynecol Scand. 1990;69:617–619. [PubMed] [Google Scholar]

52. Michalas SP, Oreopoulou FV, Papageorgiou JS. Myomectomy during pregnancy and caesarean section. Hum Reprod. 1995;10:1869–1870. [PubMed] [Google Scholar]

53. Mollica G, Pittini L, Minganti E, et al. Elective uterine myomectomy in pregnant women. Clin Exp Obstet Gynecol. 1996;23:168–172. [PubMed] [Google Scholar]

54. Febo G, Tessarolo M, Leo L, et al. Surgical management of leiomyomata in pregnancy. Clin Exp Obstet Gynecol. 1997;24:76–78. [PubMed] [Google Scholar]

55. Celik C, Acar A, Ciçek N, et al. Can myomectomy be performed during pregnancy? Gynecol Obstet Invest. 2002;53:79–83. [PubMed] [Google Scholar]

56. Brown D, Fletcher HM, Myrie MO, Reid M. Caesarean myomectomy-a safe procedure. A retrospective case controlled study. J Obstet Gynaecol. 1999;19:139–141. [PubMed] [Google Scholar]

57. Kwawukume EY. Caesarean myomectomy. Afr J Reprod Health. 2002;6:38–43. [PubMed] [Google Scholar]

58. Ehigiegba AE, Ande AB, Ojobo SI. Myomectomy during cesarean section. Int J Gynaecol Obstet. 2001;75:21–25. [PubMed] [Google Scholar]

59. Buttram VC , Jr, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril. 1981;36:433–445. [PubMed] [Google Scholar]

60. Liu WM, Wang PH, Tang WL, et al. Uterine artery ligation for treatment of pregnant women with uterine leiomyomas who are undergoing cesarean section. Fertil Steril. 2006;86:423–428. [PubMed] [Google Scholar]

61. Pron G, Mocarski E, Bennett J, et al. Pregnancy after uterine artery embolization for leiomyomata: the Ontario multicenter trial. Obstet Gynecol. 2005;105:67–76. [PubMed] [Google Scholar]

62. Walker WJ, McDowell SJ. Pregnancy after uterine artery embolization for leiomyomata: a series of 56 completed pregnancies. Am J Obstet Gynecol. 2006;195:1266–1271. [PubMed] [Google Scholar]

63. Goldberg J, Pereira L, Berghella V, et al. Pregnancy outcomes after treatment for fibromyomata: uterine artery embolization versus laparoscopic myomectomy. Am J Obstet Gynecol. 2004;191:18–21. [PubMed] [Google Scholar]


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Cumulative Risk of Adverse Obstetric Outcomes in Pregnant Women With Fibroids

FibroidsNo FibroidsP ValueUnadjusted OR (95% CI)
Cesarean delivery48.8% (2098/4322)13.3% (22,989/173,052)<.0013.7 (3.5–3.9)
Malpresentation13.0% (466/3585)4.5% (5864/130,932)<.0012.9 (2.6–3.2)
Labor dystocia7.5% (260/3471)3.1% (4703/148,778)<.0012.4 (2.1–2.7)
Postpartum hemorrhage2.5% (87/3535)1.4% (2130/153,631)<.0011.8 (1.4–2.2)
Peripartum hysterectomy3.3% (18/554)0.2% (27/18,000)<.00113.4 (9.3–19.3)
Retained placenta1.4% (15/1069)0.6% (839/134,685).0012.3 (1.3–3.7)
Chorio or endometriosis8.7% (78/893)8.2% (2149/26,090).631.06 (0.8–1.3)
IUGR11.2% (112/961)8.6% (3575/41,630)<.0011.4 (1.1–1.7)
Preterm labor16.1% (116/721)8.7% (1577/18,187)<.0011.9 (1.5–2.3)
Preterm delivery16.0% (183/1145)10.8% (3433/31,770)<.0011.5 (1.3–1.7)
Placenta previa1.4% (50/3608)0.6% (924/154,334)<.0012.3 (1.7–3.1)
First-trimester bleeding4.7% (120/2550)7.6% (1193/15,732)<.0010.6 (0.5–0.7)
Abruption3.0% (115/4159)0.9% (517/60,474)<.0013.2 (2.6–4.0)
PPROM9.9% (123/1247)13.0% (7319/56,418).0030.8 (0.6–0.9)
PPROM or PROM6.2% (217/3512)12.2% (7425/60.661)<.0010.5 (0.4–0.6)