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Complications
By Mayo Clinic staffAlthough uterine fibroids usually aren't dangerous, they can cause discomfort and may lead to complications such as anemia from heavy blood loss. In rare instances, fibroid tumors can grow out of your uterus on a stalk-like projection. If the fibroid twists on this stalk, you may develop a sudden, sharp, severe pain in your lower abdomen. If so, seek medical care right away. You may need surgery.
Pregnancy and fibroids
Because uterine fibroids typically develop during the childbearing years, women with fibroids are often concerned about their chances of a successful pregnancy.
Fibroids usually don't interfere with conception and pregnancy. However, they can rarely distort or block your fallopian tubes, or interfere with the passage of sperm from your cervix to your fallopian tubes. Submucosal fibroids may prevent implantation and growth of an embryo.
Research indicates that pregnant women with fibroids are at slightly increased risk of miscarriage, premature labor and delivery, abnormal fetal position, and separation of the placenta from the uterine wall. But not all studies confirm these associations. Furthermore, complications vary based on the number, size and location of fibroids. Multiple fibroids and large submucosal fibroids that distort the uterine cavity are the type most likely to cause problems. A more common complication of fibroids in pregnancy is localized pain, typically between the first and second trimesters. This is usually easily treated with pain relievers.
In most cases, fibroids don't interfere with pregnancy, and treatment isn't necessary. It was once believed that fibroids grew faster during pregnancy, but multiple studies suggest otherwise. Most fibroids remain stable in size, although some may increase or decrease slightly, usually in the first trimester.
If you have fibroids and you've experienced repeated pregnancy losses, your doctor may recommend removing one or more fibroids to improve your chances of carrying a baby to term, especially if no other causes of miscarriage can be found and if your fibroids distort the shape of your uterine cavity.
Doctors usually don't remove fibroids in conjunction with a cesarean section because of the greater risk of excessive bleeding.
- Haney AF. Leiomyomata. In: Gibb RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:916.
- Baird DD, et al. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. American Journal of Obstetrics and Gynecology. 2003;188:100.
- Stewart EA. Epidemiology, clinical manifestations, diagnosis, and natural history of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- The American College of Obstetrics and Gynecologists. Alternatives to hysterectomy in the management of leiomyomas. Obstetrics & Gynecology. 2008;112:387.
- Evans P, et al. Uterine fibroid tumors: Diagnosis and treatment. American Family Physician. 2007;75:1503.
- Uterine fibroids: Frequently asked questions. The National Women's Health Information Center. http://womenshealth.gov/faq/uterine-fibroids.cfm. Accessed April 22, 2009.
- Uterine fibroids. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp074.cfm. Accessed April 22, 2009.
- Stewart EA. Pathogenesis of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Management of uterine fibroids: An update of the evidence. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.ahrq.gov/downloads/pub/evidence/pdf/uterupdate/uterup.pdf. Accessed April 29, 2009.
- Stewart EA. Overview of treatment of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Marshall LM, et al. A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomata. Fertility and Sterility. 1998;70:432.
- Faerstein E, et al. Risk factors for uterine leiomyoma: A practice-based case control study. I. African-American heritage, reproductive history, body size, and smoking. American Journal of Epidemiology. 2001;153:1.
- Chiaffarino F, et al. Use of oral contraceptives and uterine fibroids: Results from a case-control study. British Journal of Obstetrics and Gynaecology. 1999;106:857.
- Stewart EA (expert opinion). Mayo Clinic, Rochester, Minn. May 13, 2009.
