Uterine Fibroids- Can I still get my baby?

In November , my friend Annabel, a mother of one, sent me a text message that read in part, ‘ … my doctor just discovered I have uterine fibroids. I am devastated and confused. Peter (her hubby) wants me to terminate the pregnancy. I really don’t know what to do …

Not knowing how to console her, I took a deep breath. The more I tried to figure out what options she had aside from terminating the pregnancy, the more confusing it got. Annabel’s SMS was a wake-up call for me. Empathising with her, I set out to read widely and gather as much knowledge as I could about the condition. Uterine fibroids are surprisingly common, but sadly most of us have remained ignorant about the condition in this information age.

About fibroids
They are non cancerous masses made of tissue from the uterine walls.Sometimes they grow within the muscular walls or the outside or inner wall of the uterus.

They can be as small as a pinhead or grow to about 20cm in size. Their prevalence rate among women of child-bearing age is as high as 80 per cent. They grow rapidly during pregnancy, competing with your baby’s growth. They thrive on oestrogen. Therefore, they are less likely to develop before the onset of menstruation during puberty. They grow during pregnancy because of the extra oestrogen produced by the body at that time. Often, the growths shrink in size returning to their pre- pregnancy size soon after delivery.

According to Dr. David Ombenqi, an Academic and Research fellow at the Duquesne University, USA, between 50 per cent to 80 per cent of all women have at least one or even up to seven uterine fibroids. Of these, 10 per cent to 30 per cent are pregnant women.

In most cases, you may not tell that you have them, as they do not display any symptoms. But sometimes, if the growths are too large or positioned In a sensitive area, you may experience uncomfortable symptoms like prolonged and very heavy periods, pain during intercourse, constipation or bloating and severe pelvic pressure and back pains.

Averagely, about 50 per cent of women suffer from the symptoms generated by fibroids at some stage of their lifetime. This means that fibroids could affect any woman regardless of her age, background, status among other external factors. Nevertheless, Dr. Ombengi says, women of African descent are more susceptible to fibroids than their white counterparts, a risk factor doctors the world over are still researching on.

Some women may simply have a genetic disposition to growing fibroids; for instance, if you have a family history of fibroids, it is more likely that you may have them. Sometimes you may develop fibroids as a result of reproductive hormones like oestrogen which studies say stimulate cell growth. Other risk factors that may predispose you to the development of fibroids include being overweight, bearing children at a younger age or a delay in having children.

Knowing the symptoms
Since fibroids do not exhibit any signs, they are often investigated and discovered during routine gynaecological or pelvic examination. Every so often your doctor may do an ultrasound scan, a laparoscopy or hysteroscopy-looking into the abdomen with a telescope and a super telescope respectively or carrying out a Magnetic Resonance Imaging (MRI) scan to diagnose them. ‘Most of these exams are done during pregnancy and that explains why a good number of women discover the fibroids when they are heavy with child,’ says Dr. Ombengi.

He goes on to explain that this condition may not affect your fertility par se, but it may pose trouble when you want to conceive, especially when the growth develops near ones fallopian tubes hence compressing them. This, he says may cause your tubes to block there by jamming sperms and eggs.

Certain types of fibroids could distort your pelvic and the uterus anatomy. This may in turn make it difficult for the fallopian tubes to capture an egg when you are ovulating and hence reduce your chances of implantation. However, if you are contemplating a pregnancy, good news is, you could still conceive. ‘The most important thing is to be aware that you have them and seek appropriate medical treatment so that they are either removed or shrunk. After completing treatment, you will then have the green light to try for a baby. In fact, some studies have shown that removing the fibroids increases your fertility by up to 70 per cent,’ says Dr. Ombengi.

Dr. Ombengi advises that you research and discuss with your doctor of the available options in getting the fibroids removed or dissolved. Some of the existing options include:

• Hormone based medication that will help relieve symptoms,
• Endometrial ablation procedure to remove the lining of your uterus using laser energy,
• Ultrasound also known as focused ultrasound surgery,
• Surgery, which entails an operation (myomectomy), which leaves the womb in place.
• It is also important to ensure you get an exam after the fibroid is removed and have regular doctor’s visits before and after you conceive.

During pregnancy
If like Annabel you discover the fibroid when already pregnant, you may likely experience slight symptoms like:

• Pelvic pain
• Light spotting especially when a growing fibroid begins to twist

In most cases, you may not experience any complication or even know that the fibroid is there. However, you have a greater chance of having a miscarriage or preterm labour. And if the baby is not more than two or three weeks premature, it should not be something to worry you.

The other issue is because of the high levels of oestrogen during pregnancy, the fibroid may enlarge and displace the placenta or generally create a Shortage of space. This may impede the baby’s growth. Sometimes the growth may obstruct the birth canal stalling labour. This will make it necessary for you to have a caesarean birth.

It is recommended that during pregnancy, you do not seek or should not be treated of fibroids; instead, your doctor should monitor you closely to track growth of your fibroids, that of your unborn baby and your health. This will help in anticipating any complications and arresting them in due time.

Should you experience pain from the condition, ‘Try lying down or even using an ice pack to numb the aching area,’ says Dr. Ombengi. ‘Immediate treatment may be considered in case you begin to bleed profusely or experience very severe pain. ‘Your doctor should also be in a position to advise you of the best delivery options for your condition. Some women push through with a normal delivery while others opt for a C-section,’ he adds.

After pregnancy, Dr. Ombengi says, the fibroids tend to shrink in size and may most likely cause you no problem. However, if you still portray fibroid symptoms, it is advisable that you seek treatment which may involve different surgeries.

END: PG 31 /42-43