Uterine Fibroids in Pregnancy: Understanding Risks & Management

Question
Dear Doctor,

I have recently got positive result in pregnancy test. My last period start date was March 11, 2006. With this I have been told that in ultrasound doctor has found Subserosal Fibroid. The Size of this fibroid is around 5.7 x 5.8cms and is placed on the posterior wall of uterus. other than this there are multiple fibroids. one on Anterior wall Size 3.4 x 2.8 cms, posterior wall 2.7 x 2.9 cms and mid part 2.5 x 2.8 cms. All fibroids bulging outside. no displacement of gestational sac. Urinary bladder normal. I am experiencing following symptoms for last one month :

- Pelvic pain which runs to my thighs but I get over with it in few minutes
- Constant Heaviness (mild)
- feel like passing stool or atleast urinate everytime it pains

other than this my last three to four periods were very painful on the first day. So much that I had to take a day off from my work each time. Bleeding was also more on the first day. This suggests that I might be having the fibroid (s) since then.
My doctor has suggested complete bed rest and has prescribed some pain killers which are to be taken if pain is very severe. She suggests that the pain will subside within a month

My questions/concerns are:

1- Is there anything alarming as far as baby's growth or delivery is concerned?

2- will the size of fibroid grow and if it does, up to what size is it harmless?

3- Are there any other suggestions to have my baby develop  in perfect shape?

4 -DOs and Don'ts

5- How frequently should I get my ultrasound done and is it harmful for baby's growth to do it often?

6- Would there be continuing problems after delivering the baby or in future conception?

I would be very grateful if you could kindly answers my questions.

Would wait for your reply eagerly

Expecting Mom
Sonal Kapur
India

Answer
As long as the fibroids do not interfere with the fetus or with the growth of the fetus, there should not be any problems. Of course, if the fibrids grow into the uterus and cause obstruction of the passage of the fetus towards the cervix, you will have to be delivered by cesarean section.I would suggest serial sonograms to assess the growth of the fibroids as well as the growth of the baby. The fibriod can grow very large without a problem as long as it is not causing any obstruction or pain.If you are more comfortable on bed rest when you have bleeding or pain from the fibroids, do so. However, it has been found that bedrest does not help. You can do a sonogram as much as your doctor wishes. If you, again, grow fibroids during your next pregnancy, or even when you are not pregnant, the same difficulties may ensue.