Understanding Prolapsed Fibroids During Pregnancy: A 36-Year-Old's Concerns

Question
I am 36 years old, pregnant with my 5th child. I was just diagnosed with having a prolapsed fibroid.  My cervix is slightly dilated because of this.  I am 8 weeks along and have had two ultrasounds and several HCG levels checked.  All came back normal.  I am concerned about risk of infection since the cervix isn't sealed up the way it should be.  Dr. seems to think the fibroid may draw itself back up into the cervix as the pregnancy progresses. I see him again in 4 weeks.  I feel great and am not having any bleeding or cramping. I did have some bleeding early on (week 4) for about 6 days due to a SCH. I am on "light" duty and pelvic rest!!

Answer
Dear Amy,

What I've heard from you sounds pretty appropriate thus far. Reproductive hormones like estrogen and progesterone can stimulate cell growth, causing fibroids to form. During pregnancy, the increase in these hormones may cause fibroids to grow in size. Though fibroids tend to grow in size during pregnancy, it is unlikely that they will cause you any symptoms. Some pregnant women do experience minor symptoms, particularly pelvic pain and light spotting. Most pregnant women who have fibroids will not experience any complications with their pregnancy either. However, fibroids during pregnancy do increase your risk of miscarriage or preterm labor slightly. Occasionally, complications can arise if your fibroids become very large. Complications can include:
-postpartum hemorrhaging
-obstructed labor (if the fibroid grows into the birth canal)
-fetal malpresentations (sometimes fibroids grow into the uterus, forcing your baby into an unusual position)
-stalled labor
-C-section

The pelvic rest and light duty at work/home sounds exactly right. And, at this point, it really is a 'wait and see' situation. As the uterus grows, the fibroid may get pulled right back up and out of the way, as your doctor suggests. As long as there is no evidence of infection at this point, I wouldn't worry over much. The amniotic sac will serve to protect the baby from sources of infection and if the fibroid inches out of the way and allows full cervical closure, the mucus plug will also be protective. But all that can be done is to monitor the progress of it and treat accordingly.

I hope this has helped you and answered your question. I wish you well.

Brenda