Fibroids during pregnancy, and minimally invasive surgical management outside of pregnancy

Written in association with: Mr Tom Setchell
Published:
Edited by: Karolyn Judge

Pregnancy can pose challenges, especially for those with fibroids. This article from leading consultant obstetrician and gynaecologist Mr Tom Setchell provides informative insights into fibroids during pregnancy, and the use of minimally invasive surgery for managing fibroids outside of pregnancy, addressing key questions individuals may have.

A pregnant person experiencing fibroids during pregnancy

Can fibroids affect pregnancy?

Yes, fibroids, non-cancerous growths in the uterus, can impact pregnancy. While many women with fibroids have uncomplicated pregnancies, these growths can cause issues such as pain, discomfort, and, in some cases, complications like preterm birth or breech presentation.

 

 

How common are fibroids during pregnancy?

Fibroids are relatively common, and their prevalence is even higher among women of reproductive age. During pregnancy, the increased blood flow and hormonal changes can sometimes lead to fibroid growth or increased symptoms.

 

 

What are the symptoms of fibroids during pregnancy?

Symptoms of fibroids during pregnancy may include:

  • Abdominal/pelvic pain

Fibroids can cause localised pain or discomfort, and can degenerate in pregnancy which causes significant pain.

  • Increased urination

Large fibroids may press against the bladder, causing a frequent need to urinate.

  • Backache or leg pains

Fibroids can exert pressure on nerves, leading to back or leg pain.

  • Complications in labour

Fibroids may contribute to difficulties during labour, necessitating careful monitoring.

 

 

Can minimally invasive surgery be performed for fibroids during pregnancy?

As a general rule we do not operate on fibroids during pregnancy.

 

 

What are the advantages of minimally invasive surgery for fibroids outside of pregnancy?

Minimally invasive surgery offers several advantages, including:

Reduced blood loss

Smaller incisions may result in less blood loss during the procedure.

 

Quicker recovery

Patients often experience a faster recovery time compared to traditional open surgery.

 

Lower risk of infection

With smaller incisions, the risk of postoperative infections is minimised.

 

 

When is minimally invasive surgery recommended?

Minimally invasive surgery is typically considered when:

Severe symptoms persist

If fibroid-related symptoms are significantly impacting the individual's quality of life.

 

Fibroid growth

In cases where fibroids enlarge, they are more likely to cause symptoms. Rapidly growing fibroids should be carefully investigated and may be more suitable for open abdominal surgery, depending on the clinical situation.

 

 

Can fibroids affect fertility or increase the risk of miscarriage?

While most women with fibroids have uncomplicated pregnancies, large or multiple fibroids can, in some cases, affect fertility or increase the risk of miscarriage. It's essential to discuss any concerns about fibroids and their potential impact on fertility with a healthcare provider.

 

 

 

If you require expert treatment for fibroids during pregnancy, or indeed outside of pregnancy, arrange a consultation with Mr Setchell. His office details are visible on his Top Doctors profile.

By Mr Tom Setchell
Obstetrics & gynaecology

Mr Tom Setchell is a leading consultant obstetrician and gynaecologist who specialises in antenatal care, care in labour, delivering babies, and postnatal care. Alongside his obstetric practice, he is also a gynaecologist specialising in minimally invasive gynaecological surgery, fibroids, endometriosis, menstrual disorders and women’s health in general.

He sees patients predominantly at The London Clinic, and also practices at The Lindo Wing at St Mary's Hospital, The Portland Hospital, OneWelbeck Women's Health, as well as King Edward VII's Hospital. His NHS base is St Mary's Hospital, part of Imperial College NHS Trust, where he maintains a special interest in minimally invasive Gynaecological Surgery and Labour Ward management. Mr Setchell has a special interest in minimal access surgery (laparoscopic and hysteroscopic surgery) and benign complex gynaecology.

His qualifications include a BMBS from the University of Nottingham Medical School (1995 - 2000) and an MRCOG from the Royal College of Obstetricians and Gynaecologists. Mr Setchell is passionate about delivering care in pregnancy, for antenatal care, delivery and postnatal care, and he manages gynaecological issues including fibroids, menstrual problems, endometriosis, pelvic pain, ovarian cysts, fertility problems and menopause. His obstetric care has an emphasis on patient choice and above all maternal and foetal wellbeing. Mr Setchell's research has been published in peer-reviewed journals. He is a member of the Royal College of Obstetricians and Gynaecologists (MRCOG), as well as The British Society for Gynaecological Endoscopy (BSGE) and the American Association of Gynaecologic Laparoscopists (AAGL).

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