Fibroid & Pregnancy
Most women with fibroids go through pregnancy without any issues. However, some women may find their fibroids grow during pregnancy causing pain due to a condition known as red degeneration. Some fibroids may prevent a vaginal delivery, so a caesarian section is needed. After delivery, most fibroids will shrink and return to their original size.
Some women with fibroids > 5cm may experience problems during pregnancy, which include:
- miscarriage (1.2x more)
- bleeding in second or third trimester
- premature birth (1.5x more)
- premature placenta separation (3.2x more)
- stillbirth (1.7% more)
When fibroid surgery is done prior to getting pregnant, two issues need to be addressed.
- The duration between surgery and future pregnancy
- The risk of the fibroid surgical site tearing during pregnancy, called uterine rupture.
After fibroid surgery, it is advisable to wait at least 6 months before trying to get pregnant. One small study using MRI to assess the healing process after fibroid surgery, found that healing is satisfactory in 70% of cases at 3 months, 80% at 6 months and 95% at 12 months.
This is the most serious complication to occur in pregnancy after fibroid surgery. Fortunately, the risk is very low, at 0.75%. It can happen in the early third trimester before labour, with significant risk to the baby. For women going into labour after fibroid surgery, there is >85% chance of a normal vaginal delivery with no uterine rupture. (Claeys 2014)
Two postulated reasons for uterine rupture are excessive thermal damage and inadequate suture repair at fibroid surgery. (Parker 2010).
To reduce uterine rupture risk, Dr Anthony Siow routinely use the ultrasonic scalpel that has a significantly lower thermal signature and barbed sutures for multi-layer closure in all his fibroid surgeries.
Consultant Obstetrician & Gynaecologist
FRCOG (UK), MRANZCOG (Aust-NZ), FAMS (S'pore)
