Fibroid and pregnancy

Effect of fibriod
pregnancy on

- iowsinlniwfwiss 1st trimeter

Uma 75 cm →
more likely to grow
Small fibroids Stable
likely to
→
more remain

Mean increase in volume nizi .

During pregnancy

Postpartum 3- 6 months → 901 in volume

.

regress
 Effect Of fibroid On
pregnancy
90% -
No
symptoms during pregnancy

Pain
-

( most common symptom ) -

correlates with size
( 75cm )
Pelvic
-

pressure

Vaginal bleeding
-

Waves fibroid do fetus

1.
Miscarriage
[ aobDW7i8na
sub mucous
2. Preterm labor ,

wonnnoriowiuwiotun
'

3 . Mal presentation
4 . Fetal anomalies ( rare )

5 .
Fetal growth restriction ( small effect )
 Waqos fibroid monism

1 .
Antepartal bleeding Gautam : visa sub mucosal
,

Placental placental fibroids

2.
abruption retro ,

volume ml )
'
> 200 ( 07 8
Dysfunctional labor
-
cm
3 .

d. force OF UC

4 . Cesarean
delivery
5 . Postpartum hemorrhage
g. preterm PROM Placenta
, Previa
⇒
)
] jvnbow
pre
.
eclampsia
 Management

a
During pregnancy

supportive care for pain

Acetaminophen

NSAIDS ( ( 32 WK )

sit premature closure of ductusarteriosus

neonatal pulmonary hypertension

oligohydramnios
fetal neonatal platelet
/
dysfunction
Opioid shorterm
-

-
Use

Epidural analgesia
-
( refractory to other Tx )
on
pro lapsing fibroid into the vagina
-
observe
-

Ix for removal bbwihh trans Vaginal resection

Clinically significant bleeding

Excessive
-

pain , urinary re tension and infection ( rare )

eo Ix for myomectomy during pregnancy

1) Hemorrhage ( Uncontrollable oiooios hysterectomy )
2) Uterine
rupture
3) miscarriage
-
Best avoided -

4) Preterm delivery
 •
During labor

1. Vaginal delivery ( most )

Cesarean
2. delivery

× -

obstetrical indication

Incision
-

fetal Mal presentation

Classic
failure
-

to
.

progress
-
-

post .

hysterotomy
non
reassuring fetal
testing avoid transecting
a fibroid

Large
←

cervical fibroids
Myomectomy during US

↳ Should be avoided
Lower uterine
-

segment fibroids