Pregnancy by Trimester When You Have Fibroids

Pregnancy by Trimester When You Have Fibroids

Becoming pregnant can be an exciting time for families. Unfortunately, women with fibroids may be concerned about fibroid-related pregnancy complications, and research suggests that they have reason to be. Learn more here about the common questions asked regarding pregnancy and fibroids, along with treatment options to consider before getting pregnant.*

Do fibroids grow with pregnancy?

For some women, new fibroids may grow and existing fibroids may get bigger during pregnancy. This is because your body produces more estrogen during pregnancy, and fibroids are sensitive to estrogen. In other women, however, there may not be any change in fibroid growth during pregnancy. 

Interestingly, most fibroid growth occurs during the first trimester. As the baby grows more in the second and third trimesters, there is very little fibroid growth. 

What can happen in the second and third trimesters?

There are, however, complications that may arise during the second and third trimesters. These include:

  • Painful symptoms such as fever and abdominal tenderness, which are often experienced with large fibroids over five centimeters in diameter, and pedunculated fibroids. 
  • The placenta, which provides oxygen and nutrients to the baby, may become partially or completely separated from the uterus before birth. This can lead to preterm labor and/or fetal growth restriction. 
  • A cesarean section (C-section) may be needed if a fibroid blocks the birth canal or prevents the uterus from contracting properly. 

Can fibroids cause a miscarriage?

Yes, fibroids can lead to a miscarriage. The highest risk for a miscarriage is during the first trimester. If the fibroids become very large or you have numerous fibroids, your risk may be even higher. 

What are the concerns after delivery? 

Immediately after delivery, the most likely potential complication is postpartum hemorrhage, which refers to excessive bleeding after delivery. Beyond delivery, fibroids usually shrink and cause fewer symptoms. If you do continue to experience symptoms, however, it’s important to discuss them with a fibroid specialist. 

How do fibroids affect pregnancy?

Having fibroids can make it more difficult to get pregnant. In particular, submucosal fibroids (fibroids that grow within the endometrium) may increase the risk of infertility. Depending on their location and size, they may pose a higher risk of miscarriage and cause heavy menstrual bleeding. 

What treatment options are there before pregnancy? 

While the fibroid complications associated with pregnancy can be intimidating, there are treatments to help you better conceive and have a safer pregnancy. Speaking with your doctor prior to getting pregnant can help you to determine the degree of risk that pregnancy may have for you, and to make informed decisions about your treatment. Some treatments that may be discussed include:

  • Myomectomy, where the fibroids are surgically removed in a hospital setting and the uterus is preserved, though scarring may occur
  • Uterine fibroid embolization (UFE), a minimally-invasive, outpatient procedure that shrinks fibroids by cutting off their blood supply
  • Radiofrequency ablation (RFA), which shrinks fibroids by using heat to kill the fibroid tissue directly

Addressing your fibroid concerns prior to pregnancy is important to ensure the safety of your baby and yourself. 

*Chambers, C. (2022, September 29). Uterine fibroids and pregnancy during each trimester. USA Fibroid Centers.