Last Wednesday's "Doctor Concord said" told the story of a 40-year-old elderly mother with uterine fibroids, Xiao A, I believe everyone understands that pregnant mothers have many risks associated with uterine fibroids, so how to prevent it? Don't worry, today, the obstetricians of Peking Union Medical College Hospital will continue to answer your questions -
About the author: Ma Liangkun
Chief Physician of the Department of Obstetrics, Peking Union Medical College Hospital, specializes in perinatal health care, obstetric complications and comorbidities, prenatal diagnosis and genetic counseling.
What discomforts can I cause with pregnancy or uterine fibroids?
First, pregnant mothers need to understand the various discomforts that pregnancy and uterine fibroids can cause. Pregnant mothers may experience discomfort in the lower abdomen due to uterine growth, pain in the pulling of the round ligaments, pelvic girdle pain and uterine sensitivity due to insufficient strength of the core muscles, uterine contractions during threatened miscarriage or preterm birth, and local pain due to degeneration of uterine fibroids.
Tenderness in the round ligament is a normal manifestation of the body's adaptation to the state of pregnancy. When there is a sudden change in position, such as a sudden change from sitting to standing, excessive twisting of the pelvic area, or laughter and coughing that increase abdominal pressure, the round ligament may be pulled by external forces, causing pain. This pain often occurs in the lower abdomen (one or both sides), hip joints, and groin areas (oblique depressions at the base of the thighs), and the pain is mostly sharp, strong and short-lasting (usually lasting several minutes), which is the kind of "twitching pain" described by pregnant mothers.
The core muscle group is the intermediate link of the human body, which is responsible for stabilizing the body's center of gravity, conducting strength, etc., and is the "energy source" of the body. Women who are sedentary in the office and lack exercise will have insufficient strength of abdominal muscles, gluteus major muscles, gluteus muscle weakness, and over-tightening of the erector, psoasteas muscles, latissimus dorsal muscles and iliopsoas muscles, so that uncoordinated muscle groups can lead to pelvic leaning forward, and "inferior crisscross syndrome" occurs, which is the main cause of low back pain.
During pregnancy, the uterus rapidly enlarges, the abdomen gradually bulges so that the bilateral rectus abdominis, abdominal oblique muscles, abdominal oblique muscles, etc. are gradually stretched to the limit, the contraction capacity and elasticity of the abdominal muscles are significantly reduced, coupled with the pregnant mother's daily incorrect posture, the secretion of relaxin, and the lack of strength of the core muscles, which will lead to back pain, abdominal wall tension, uterine sensitivity, and bladder compression. Some pregnant mothers will have uterine contractions after the bladder is full (holding urine) and walking activity because of the sensitivity of the uterus.
Uterine contractions that occur during threatened miscarriage or threatened premature birth are similar to the discomfort, soreness, throbbing pain, and pulling pain in the middle of the lower abdomen during menstruation, which may last for more than ten seconds, usually not more than one minute, and pregnant mothers should learn to observe the degree, duration, interval and possible precipitating factors of pain.
By recording her own feelings and states and actively communicating with doctors, the pregnant mother Xiao C, who has contractions in the second trimester, found that the feeling of contractions is related to posture, exhaustion, urination, constipation, etc., and the pain score ranges from 1 to 3 points, which is related to the lack of strength of the core muscles leading to uterine sensitivity. Through self-observation, relaxation and stress reduction, symptom record analysis, and regular obstetric monitoring, Little C gave birth at the end of term, and we also received a warm thank-you note:
Thank
"Hello Dr. Ma, and you announce the good news, I gave birth to 7 pounds of female treasure last night, although the process is a little difficult, but the baby is healthy and cute and very satisfied!" Thank you very much for your guidance, let me understand the importance of diet and exercise during pregnancy, the concept of healthy diet plus reasonable exercise has been deeply rooted in my heart, I believe that it will have a positive impact on later life. Thank you even more for giving me confidence on the road to keeping the baby alive until 39+ weeks. Thank you again, and I wish you all the best in your future life and work. ”
Finally, there is local pain caused by denaturation of uterine fibroids. Uterine fibroids are red degenerated, manifested by rapid enlargement of fibroids, abdominal pain, fever, and elevated blood picture. This pain is usually locally pronounced by uterine fibroids, with tenderness, rebound pain, accompanied by fever, symptoms of infection, and may also be accompanied by painful discomfort with contractions.
What should pregnant mothers do?
Back to the little A mentioned at the beginning, she came to the outpatient clinic for a routine obstetric examination at 13 weeks of pregnancy. The examination found that the base of the uterus of Little A was located under the umbilicus, Doppler auscultated to the fetal heart, the corners of Little A's eyes were flooded with tears of excitement, and the baby's fetal heart was recorded as a souvenir, and then we told Little A the location of the uterus and fibroids, the possible feeling of uterine growth, and the painful characteristics of round ligament pulling pain, uterine contraction and fibroid degeneration.
Under our guidance, Little A understands to learn to observe pain and discomfort, if the pain is frequent and persistent, accompanied by severe abdominal pain, bleeding, colic, fever, chills, nausea, vomiting or abnormal changes in vaginal secretions, should go to the hospital emergency department in time to seek medical treatment, clarify the cause, and treat the symptoms. At the same time, Xiao A also understood that it is necessary to learn not to amplify the feeling of discomfort, not to overly nervous and anxious and lead to frequent medical treatment.
Psychological counseling during pregnancy can help pregnant mothers adjust their emotions and maintain a peaceful attitude. Nutritional management can help prevent the development of anaemia, macrosomia, or small-for-gestational-age infants. A healthy lifestyle that includes preventing colds, diarrhea, vaginal inflammation, and eating less inflammatory diets such as barbecue and frying can prevent preterm birth due to various infections and inflammatory states.
The body composition of Small A shows insufficient muscle strength, so it is also particularly important to strengthen the strength of the core muscle groups, otherwise as the uterus continues to grow, there will be a hanging abdomen, laxity of the stomach and sagging abduction, further aggravating its discomfort. Therefore, it is also necessary to maintain a healthy posture, exercise reasonably and effectively under the guidance of a coach, and observe the symptoms of discomfort.
To sum up: advanced age, IVF, various disease states, etc. are not things that we can change in a short period of time, or even cannot be changed, we can only accept it calmly and do the best we can within our own capabilities.
Each pregnant mother's pregnancy process is a unique experience, and every small fragment of this experience may have some impact on the growth and development of the baby and the future growth, we hope that every pregnant mother can harvest the most intimate memories with the baby in this precious pregnancy process, with the help of this pregnancy, completely improve their own and even the family's diet structure, exercise habits, reduce the incidence of diseases related to bad lifestyle, harvest healthy babies while restoring a healthy and tight good body! I hope that all pregnant mothers can be optimistic, enthusiastic, love life, and love themselves!