What Are Fibroid

Uterine fibroids which are also called myomas or leiomyomas are also benign noncancerous tumors of muscle tissue in the uterus. Over multiplication of a single muscle cell in the wall of the uterus can grows to form a fibroid which is a noncancerous tumor. Fibroid, because of its growth in an unfavorable position or area in the uterus tends to change the shape or size of the uterus and sometimes the cervix (lower part of the uterus).

Fibroid usually grow and are found in or around the body of the uterus, but sometimes you find them in the cervix. Sometimes you can have floating fibroid i.e. it is not attached to the walls of the uterus, but some are attached to the uterus by a stalk (pedunculated).  Few are found attached to ligaments and organs that are closed to the uterus such as the bladder and bowel. Fibroid rarely grow outside the pelvic cavity.

Can fibroid affect your fertility?

It is not common for fibroid to cause infertility but depending on their size and location, some fibroid do cause infertility. For example, it can interfere with the sperm’s inability to get to the egg for fertilization. It is also possible for fibroid to affect fertility if they’re positioned in the uterus where the baby needs to be during pregnancy. Most times when this occurs, doctors will always advise leaving fibroid while the pregnancy will be monitored.  

Fibroid are that are embedded in the submucosal, can affect fertility. Fibroid most time does not affect ovulation, but if the fibroid is in the submucosal, it can make it harder for your uterus to support conception and maintain pregnancy. Sometimes this type of fibroid can cause pregnancy loss.

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How do fibroid cause infertility?

Fibroid that are embedded in the uterus can cause infertility in the following ways: 

• There is a possibility of changing the shape of the cervix and this can affect the number of sperm that enters the uterus.
• Has the possibility of changing the shape of the uterus and this can interfere with the movement of the sperm or embryo.
• It can block the fallopian tubes.
• The size of the lining of the uterine cavity can be affected by the presence of fibroid.
• It can decrease the uterine cavity’s blood flow and this can affect an embryo from sticking to the uterine wall when it’s growing.

What are the effects of fibroid on pregnancy?

During pregnancy, most women don’t experience the effect of fibroid apart from few cases of complication. The most common complication of fibroid during pregnancy is pain and these results from fibroid larger than 5 centimeters and who are in their last two trimesters.

It is also of note that during pregnancy, fibroid can facilitate premature delivery or miscarriage and this often happens when the baby’s position in the uterus is altered. In case you’re unfortunate to have fibroid during pregnancy, the best you can do is to discuss the birth plan options with your doctor. Most confirmed cases of women affected with fibroid during pregnancy (depending on the size) opt for a cesarean section to deliver their baby.

During an ante-natal clinic in early pregnancy, it's not uncommon to diagnose a patient with pre-existing conditions of fibroid. This early detection allows the doctor to know how to manage the pregnancy till the point of delivery. While diabetes and high blood pressure are the common focus during an ante-natal clinic, but 1% to 10% of expectant moms are found to have uterine fibroid at prenatal ultrasound diagnosis. Fibroid from pregnancy to delivery can cause several complications which are:-

Fetal risks

During pregnancy, the risk to the growing baby is always low. But large or multiple fibroid we'll watch closely for a few potential concerns:

1. Abnormal placenta:Placenta previa i.e. implantation of the placenta over the cervix and placental abruption i.e. premature separation of the placenta from the uterus has been associated with fibroid. How do you diagnose this? During antenatal clinic by the use of ultrasound to check the placenta.
2. Fibroid growth/Fetal growth:According to research studied, two-thirds of fibroid likely will grow or shrink during pregnancy and if it occurs, it's typically during the first trimester. You can use ultrasound to monitor changes in the uterus and evaluate the growth of your baby in comparison to your fibroid. Researches have not pinned down the correlation between fibroid and fetal growth restriction.
3. Breach baby position:At times, this breach position occurs in pregnancy when fibroid limit the space in the uterus. This can result in your baby breached bottom down instead of head down. Ultrasound and a physical exam can be used to monitor the baby's position, especially as you get closer to your due date of delivery. A cesarean section (C-section) might be recommended if your baby is not head down. 
4. Preterm delivery: The size of the fibroid might cause stress on the uterus. And continuous stress on the uterus might lead to preterm contractions or premature rupture of membranes and subsequent delivery.                                                        

Pregnant Risk:

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The complication of fibroid in pregnancy to potential labor and delivery includes things as:

• Cervical blockage:When the lower part of the uterine area is crowded with objects like bulky fibroid, it might block or narrow the opening of the birth canal. This kind of obstruction can lead to the risk of needing a C-section.
• Poor contracting:When the normal functions of the uterine tissue are disrupted because of the presence of fibroid in it, this may result in weak contractions. And this can finally result in difficulty to reach complete cervical dilation during labor and may call for C-section delivery.
• Postpartum hemorrhage:This condition occurs when the uterus is unable to contract normally after delivery thereby making the uterine blood vessels that feed the placenta continues to bleed. When this occurs, the attention of the medical staff has to be notified because excessive bleeding can lead to gross anemia.

Vaginal delivery is often possible and is generally preferred by some in other to avoid the risks associated with C-sections. But if you have fibroid and wish to start a family, the best is to discuss with your health consultant about your options for treatment and risks management. Your wise consultation and decision with your health consultant will give you the courage to sail through your pregnancy (despite the fibroid) from the early stage to delivery.

Although it is difficult to prevent fibroid, a healthy lifestyle can minimize the chances of if developing.

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