Don’t let “tonics” kill you

After a woman with uterine fibroids becomes pregnant, in most cases the pregnancy can continue, but a comprehensive assessment is required based on the size, location and risk of complications of the fibroids. The management of uterine fibroids combined with pregnancy mainly includes regular monitoring, drug control, and surgical intervention when necessary.

1. Regular monitoring

Changes in fibroids need to be closely observed through ultrasound during pregnancy. Submucosal fibroids or intramural fibroids larger than 5 cm in diameter may affect fetal development, and fibroid growth needs to be evaluated every 4-6 weeks. The focus of monitoring includes whether the placenta is compressed by fibroids and whether there are symptoms such as abdominal pain caused by red degeneration.

2. Drug control

Acetaminophen tablets can be used for a short period of time when the pain of fibroid degeneration occurs. Ritodrine Hydrochloride Injection must be used under the guidance of a doctor when severe uterine contractions occur. NSAIDs are contraindicated as they may cause premature closure of the fetal ductus arteriosus. Progesterone capsules may help maintain a stable pregnancy.

3. Surgical intervention

Myomectomy may be considered in the second trimester when fibroids cause recurrent miscarriages, severe pain, or fetal growth restriction. Surgical risks include bleeding, premature birth, etc., and need to be evaluated by an experienced obstetrician. Pedunculated subserosal fibroids are more likely to undergo torsion and require emergency treatment.

4. Mode of delivery

Cesarean section is recommended when fibroids are located in the lower segment of the uterus and may block the birth canal. In most cases, vaginal delivery can be attempted. Postpartum patients need to be alert to bleeding caused by uterine atony, and use carboprost tromethamine injection to promote uterine contractions if necessary.

5. Nutritional management

Supplement 0.4-0.8 mg of folic acid tablets daily to prevent neural tube defects and increase the intake of iron-rich foods such as beef and spinach. Limit foods high in phytoestrogens, such as soy products, to avoid stimulating the growth of fibroids. Staying moderately active can help control your weight and blood sugar.

Obstetric examinations should be performed every 2-4 weeks during pregnancy. If vaginal bleeding, persistent abdominal pain or abnormal fetal movements occur, seek medical attention immediately. The changes in fibroids need to be reviewed 6 weeks after delivery. After the lactation period, further treatment options can be decided based on the condition of the fibroids. Avoid strenuous exercise and abdominal compression on a daily basis, and sleep on your left side to improve uteroplacental blood flow.