Fibroids During Pregnancy: Risks, Monitoring and Management

Finding out you have fibroids during pregnancy can be unsettling, especially when you are already navigating the physical and emotional changes that come with expecting a baby. While most fibroids do not prevent a healthy pregnancy, their presence can raise understandable questions about potential risks, monitoring and delivery. Understanding how fibroids may affect your pregnancy can help you feel more reassured and better prepared for the months ahead.

What Are Fibroids and How Common Are They During Pregnancy?

Fibroids are non-cancerous growths that develop from the muscle layer of the uterus. They can vary in size, number and location and are commonly found in women of reproductive age. Some women may know they have fibroids before becoming pregnant, while others only discover them during routine antenatal ultrasound scans.

Fibroids are not uncommon in pregnancy and in many cases, they do not cause significant problems. Their impact largely depends on factors such as size and position within the uterus. Many women with fibroids go on to have smooth pregnancies and healthy deliveries, especially with regular monitoring and appropriate obstetric care.

What Are the Risks of Fibroids During Pregnancy?

Most women with fibroids go on to have healthy pregnancies. However, depending on the size, number and location of the fibroids, certain risks may be slightly increased. Possible concerns include:

• Abdominal pain, particularly if a fibroid undergoes degeneration (when it outgrows its blood supply).

• Vaginal bleeding, especially in early pregnancy.

• Pressure symptoms, such as pelvic discomfort if the fibroid is large.

• Placental position issues, depending on where the fibroid is located.

• Preterm labour, although this is less common.

It is important to remember that not every woman with fibroids will experience these complications. Regular antenatal monitoring allows your obstetrician to assess any changes and guide appropriate care to support both mother and baby.

How Are Fibroids Monitored During Pregnancy?

When fibroids are present during pregnancy, regular monitoring helps ensure both mother and baby remain well. Fibroids are often identified during routine antenatal ultrasound scans, where their size and location are assessed.

During follow-up visits, your obstetrician will monitor whether the fibroid changes in size, particularly as hormonal levels rise in pregnancy. The baby’s growth and position are also assessed, especially if a fibroid is large or located in a way that may affect the uterine space. In some cases, placental position may be reviewed more closely if a fibroid lies nearby.

Most fibroids remain stable and do not significantly interfere with pregnancy. Consistent antenatal care allows any changes to be detected early and managed appropriately, providing reassurance throughout the pregnancy journey.

How Are Fibroids Managed During Pregnancy?

In most cases, fibroids are managed conservatively during pregnancy, with the focus placed on monitoring and symptom relief rather than surgical removal. This is because removing fibroids during pregnancy carries higher risks and is rarely required.

If discomfort occurs, safe pain relief medications may be prescribed and adequate rest and hydration are often recommended, particularly if the pain is due to fibroid degeneration. Your obstetrician will continue to monitor the fibroid’s size and position throughout pregnancy, especially if it is large or located near the placenta.

Delivery planning is also individualised. Many women with fibroids can still have a vaginal birth but if a fibroid affects the baby’s position or obstructs the birth canal, a Caesarean section may be advised. Careful monitoring and personalised planning help support a safe pregnancy and delivery.

When Should You Speak to Your Obstetrician?

While most fibroids do not cause serious complications during pregnancy, it is important to seek medical advice if you experience unusual or concerning symptoms. Early assessment allows your obstetrician to determine whether the symptoms are related to fibroids or another pregnancy-related condition.

You should contact your doctor if you notice:

• Severe or persistent abdominal pain.

• Heavy vaginal bleeding.

• Fever accompanying abdominal discomfort.

• Signs of preterm labour, such as regular contractions or pelvic pressure.

• Reduced fetal movements in later pregnancy.

Supporting a Healthy Pregnancy with Fibroids

Fibroids during pregnancy are often manageable with careful observation and tailored care. Staying informed and attending regular antenatal visits can provide reassurance at every stage, while early evaluation of new symptoms allows for timely support when needed.

At GynaeMD Women’s Clinic Clementi, fibroids in pregnancy are managed with careful assessment and individualised care planning. Dr Regina Zuzarte-Ng adopts a patient-centred approach, taking time to understand each woman’s concerns and tailoring care accordingly. For personalised guidance on fibroids during pregnancy, arrange a consultation with our clinic today.