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Uterine fibroids are common and are found in up to one in 10 pregnancies. Although most pregnancies involving fibroids are uncomplicated, some women have a higher risk of pregnancy and birth complications depending on the size, number, and location of the fibroids. This narrative review summarizes current evidence and clinical recommendations from published research on fibroids and pregnancy. The review concludes that most women with fibroids have healthy pregnancies, while larger, multiple, or lower uterine fibroids may require closer monitoring and individualized care.
Fibroids are noncancerous growths that develop in the uterus. During pregnancy, they may change in size because of hormonal and other biological changes. While many women do not experience symptoms, some fibroids can increase the risk of complications during pregnancy and birth. Understanding these risks helps guide pregnancy with fibroids and appropriate care.
This review brings together published studies and clinical guidance on caring for women with fibroids before, during, and after pregnancy. It summarizes current evidence on pregnancy risks, monitoring, treatment, birth planning, and postpartum care to support individualized clinical decision-making.
The review found that most pregnancies involving fibroids are uncomplicated. However, women with multiple fibroids, fibroids larger than 5 cm, or fibroids located in the lower uterine segment have a higher risk of complications. These include preterm birth, fetal malpresentation, placental abruption, placenta previa, cesarean birth, and postpartum hemorrhage. The most common pregnancy complication is red degeneration, which usually causes pain and is managed conservatively. Even with these increased risks, most women with fibroids are able to have a vaginal birth, and cesarean birth is generally performed only for standard obstetric indications.
Fibroids often enlarge during early pregnancy, stabilize later, and commonly shrink after childbirth. Breastfeeding may also contribute to stable or smaller fibroids because hormone levels remain lower after birth. Ultrasound is the recommended method for monitoring fibroids during pregnancy, while MRI may be helpful in selected situations when additional information is needed for diagnosis or birth planning.
For parents and healthcare professionals, the review highlights the importance of individualized care. Decisions about monitoring, treatment, and birth planning should consider the woman’s symptoms together with the number, size, and location of the fibroids. Conservative management is appropriate in most cases, while surgery during pregnancy is reserved for selected situations when symptoms cannot be controlled or complications develop. Most women with fibroids can expect a generally uncomplicated pregnancy with appropriate care.
Paper Available At: International Journal of Gynecology & Obstetrics
Full List of Authors: Ramasauskaite, D.; Purandare, N.; Diaz, I.; Kvederaite-Budre, G.; Beyuo, T. K.; Beyeza-Kashesya, J.; Jacobsson, B.
DOI: 10.1002/ijgo.70612
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