Uterine fibroids are largely an estrogen-dependent tumor and are a common condition in women of reproductive age. It can be said that the relationship between uterine fibroids and pregnancy and childbirth is constantly shearing and messing. We tried to sort out the relationship between uterine fibroids and pregnancy from the following aspects.
I was planning to get pregnant, but I found uterine fibroids on examination, what should I do?
In general, if the relationship with pregnancy and childbirth is not considered, only those with special locations, excessive menstrual flow, menstrual inexhaustible menstruation, anemia, or fibroids with a diameter of more than 5 cm require surgery.
For women who are preparing to become pregnant, the indications for treatment should be appropriately relaxed.
For submucosal fibroids located in the uterine cavity, treatment is recommended before pregnancy, regardless of whether they have symptoms (usually menorrhagia or menstrual inexhaustibility) because they may prevent future embryos from implantation. Hysteroscopy is currently considered to be the best method. Since there is no need to incise the abdomen, recovery is usually faster after surgery.
So, how big are the uterine fibroids before pregnancy that require surgery?
Unfortunately, there are no clear provisions at this time. In clinical practice, some medical units (such as Peking Union Medical College Hospital) believe that if uterine fibroids do not exceed 4 cm in diameter between myoids or subserosal fibroids, patients can consider pregnancy. However, patients need to be aware that during pregnancy due to a sharp change in the blood supply to the uterus, fibroids may grow rapidly, ischemia may occur and lead to red degeneration, or when the position of the uterus changes, subserous fibroids twist. Both conditions can cause severe abdominal pain, triggering a miscarriage or premature birth.
If the fibroids are located at the lower end of the uterus, that is, the cervix (sometimes fibroids are more than 2 cm in diameter), or if the fibroids in other areas are larger than 4 cm in diameter, or if the patient has a history of infertility or multiple spontaneous miscarriages and cannot find another clear cause, it may also be considered to have the fibroids removed before becoming pregnant, although the fibroids are less than 4 cm in size. As for whether laparoscopic surgery or open surgery to remove fibroids, there are pros and cons.
Assuming that a fibroid removal is performed, how long does it take to get pregnant after the procedure?
Generally speaking, if the fibroids are located between the muscle walls or under the serous membrane, the number is not large, the integrity of the wall of the uterine muscle layer is not obvious, and the entire layer is not broken into the uterine cavity, and the postoperative contraception can be prepared for pregnancy for 6 months;
If the number of fibroids is large, multiple openings are made in the uterine wall, causing great damage to the integrity of the uterine wall, or entering the uterine cavity during culling, or the culling process is particularly difficult, it is recommended to use contraception for at least one or two years before considering pregnancy.
Of course, for those subserosomyomas connected to the uterus through the slender peduncles, if the operation is as easy as picking apples or grapes, there is almost no damage to the integrity of the uterine wall, and after the operation, a single menstruation, or at most 3 months of contraception, can prepare for pregnancy.
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