Fibroid tumours
I'm 23 weeks pregnant and have several fibroid tumours. The largest is about 10cm in diameter. My last ultrasound showed that there had been an increased growth in the past five weeks and that part of this tumour is degenerating. I feel great but have occasional sharp pains in my lower left side where the tumour is. The baby has moved every day for three weeks and the ultrasound showed normal growth. What can happen with a degenerating fibroid during pregnancy?
About 1 in 200 pregnancies are affected by fibroids. Most are small and cause no trouble. But roughly 1 in 800 can cause complications. Major problems, though unlikely, do occur. The severity depends on the number, the size and the position in the womb of the fibroids.
There is always an increase in the blood vessel supply to the womb during pregnancy and this, along with raised hormone levels, leads to an increase in size of the fibroids. So the fact that your ultrasounds have shown this will be of no surprise to the obstetricians.
Between the 12 - 22nd week of pregnancy some people get lower tummy discomfort and tenderness, accompanied by mild fever. Treatment is rest and sedation for a few days, which should allow the discomfort to settle.
Some mums experience a 'pressure' when the fibroid is large and positioned at the back of the womb - often felt in the rectum. The pregnancy itself is unaffected.
On some occasions, and this seems to have happened in your case, the blood supply to the fibroids becomes less efficient and they begin to break down. This is termed 'degeneration'. The treatment, again, is usually conservative and involves bedrest and simple painkillers. No operation is usually necessary.
Since the fibroids do increase in size during pregnancy, they may occasionally become trapped deep in the pelvis, but this is rare. The effect on pregnancy depends upon the size and the position of these tumours. Unfortunately, in some cases, early miscarriage or premature labour does occur. Large tumours occasionally cause the baby to lie in and awkward position. If they are near the lower end of the womb, they may even cause the labour to become obstructed - a Caesarean section would then be performed.
Nowadays, of course, with all of the sophisticated, non-invasive examination equipment available, there is very little which we are not able to discover in the early days of pregnancy. We are now able to avoid the 'surprises'.
When the fibroids have been diagnosed before labour, no treatment is generally indicated, and these fairly common tumours can be monitored as your pregnancy continues. They do not cause any alteration to the type and quality of the contractions in the first two stages of labour.
So, now armed with a little more knowledge, I hope that you are able to continue to enjoy your pregnancy.
Family GP
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