Fibroids and pregnancy

The prevalence of uterine fibroids in pregnancy varies between 1.6% and 10.7%. Pregnancies involving uterine fibroids are generally uncomplicated. However, complications can occur, particularly in cases of multiple fibroids, when the fibroids are larger than 5 cm, or when they are located in the lower uterine segment. Between 10% and 30% of pregnant women with fibroids experience complications during pregnancy, labor, and the postpartum period. The most common complication during pregnancy, which can occur in 8% of women, is red degeneration. High-quality data on the relationship between fibroids and pregnancy outcome are very limited. Potential obstetric complications include preterm birth (increased risk, OR 1.5; 95% CI, 1.3–1.7), malpresentation of the baby (OR 2.65; 95% CI, 1.60–3.70), placental abruption (OR 2.63; 95% CI, 1.38–3.88), placenta previa (OR 2.21; 95% CI, 1.48–2.94), cesarean birth (OR 2.60; 95% CI, 2.02–3.18), postpartum hemorrhage (OR 2.95; 95% CI, 1.86–4.66), and other rare occurrences. Most women with uterine fibroids are able to deliver vaginally without complications. Cesarean birth is typically performed for standard obstetric indications. It is recommended that cesarean myomectomy should be avoided when possible.