Specialist Answer Questions On Fibroids Occurring With Pregnancy

Fibroids are a common occurrence in women and many women who have this problem do not even realise that they have it. This is particularly so in the vast majority of women in whom the fibroids are small and therefore, not noticeable.

Fibroids can vary in size from the size of a groundnut seed to a watermelon. Sometimes, they are as heavy as five kilogrammes or even more. They are growths arising from the muscle cells of the body of the womb from where they can expand in various directions.

It may be into the wall of the womb or towards its outermost layer or into the cavity of the womb. Each of these different growths has a unique name which is not important for this essay.

Among all of these variants, it is perhaps the ones that grow into the cavity of the uterus and the ones which grow within the muscle layers that cause the most trouble as we will explore below.

However, it needs to be stressed strongly that fibroids do not usually affect pregnancy in any profound way. As for the cases in which the fibroids are large enough to become noticeable, such a growth can negatively impact on the growth of a foetus inside the womb, by preventing its adequate development.

It can even prevent a pregnancy from happening and even though this is not our focus today, it is not a common occurrence. In some cases, the fibroid is so large that even in the course of a normal pregnancy there may be pain and tension all over the tummy.

In addition, there is an increased need to urinate while constipation may become an added problem. The frequency of urination is caused by the extra pressure exerted upon the urinary bladder by the fibroid such that the bladder is reduced and it becomes full of urine almost as soon as one has passed some urine.

In addition, there are severe abdominal cramps which would mimic menstrual cramps. For those women who never experienced cramps during their monthly period, it would be a new experience. Their presence together with a pregnancy can cause a premature labour to happen leading sometimes to the delivery of preterm babies and low birth weight babies also.

It may also cause foetal loss and depression in the mother. Such preterm labour can be caused by the specter of the membranes braking prematurely such that the water around the baby is caused to pour out of the womb.

Furthermore, because the large fibroids often occupy a large portion of the womb, they may force a baby into an abnormal position thus increasing the risk of having a caesarian section. In a similar way, they can even obstruct labour thus making an operative delivery more likely.

Yet, in many communities within Nigeria, some women would reject even this option of ensuring that they deliver safely because of their fake beliefs and village value system. That system suggests to them that if they deliver operatively, they are somehow less of a woman than those who do so normally.

SEE ALSO: Find Out From Gynaecologist, Prof. Rotimi Jaiyesimi If Fibroids Prevent A Woman From Getting Pregnant Or Not

Sometimes, some women in this condition may experience some vaginal bleeding before delivery. This is one of the less common causes of ante-partum haemorrhage as it is termed but the bleeding can be repetitive and serious.

Besides that, similar bleeding can occur after delivery when it is called post-partum haemorrhage which can happen either because the surface area of the fibroid involved is considerable due to its sheer area or because the uterus fails to contract adequately to reduce the loss of blood from its walls.

During an operative delivery, the obstetrician may choose to remove the fibroids as well in a procedure known as caesarian myomectomy to preserve the uterus for the possibility of another conception in the future.

It remains a dangerous undertaking to do so because there are times when the resulting blood loss from such an operation may be impossible to control. Despite these concerns, however, this twin procedure is gradually becoming more popular among many obstetricians.

Consequently, it can be seen from the above that the prospect of having fibroids, also called leiomyoma, coexisting with pregnancy has a wide variety of effects depending on the individual involved. As a rule, therefore, once a fibroid is determined as posing a risk to the health of a particular pregnancy or even of the woman herself, an operation is required to save mother and baby.

It is important, therefore, that a woman who has been diagnosed with fibroids should volunteer to give that information to the healthcare personnel of any hospital or other health care facility they opt to have their treatment in. When this is done, such a woman can have proper treatment when a problem develops in the course of the pregnancy and deal with any uncomfortable symptoms arising from it.

Fibroids are a common occurrence amongst women. In some estimates, some 40 to 80 per cent of all women whatever the race is said to be variously affected but most will not require any treatment. In some situations where heavy bleeding during the course of removing fibroids associated with a pregnancy occurs, the entire uterus is removed by the doctor to save her life since the baby is presumably safe.

There is no use being emotional about the choices available as only a few minutes are often available to avert disaster in situations like that. There have been situations in the past when family members, usually husbands, hesitated to give the required consent promptly and the worst happened or they were busy conferring outside the operating room while blood oozed away from their wives.

Fibroids are non-cancerous growths frequently found in the womb of women in the reproductive age and particularly from 16 to 50 years. It is, therefore, no surprise that these growths can also coexist with a pregnancy.

Beyond these reasons, it is not known precisely why fibroids form and how they develop. Nor is it clear why they are mild in some people and bad in others to the extent of even requiring more than one operation to get rid of the problem. In the main, complications are rare in pregnancy but they can be serious when they occur.

ALSO READ: Fibroids and Painful Sex, OBGYN Abosede Lewu Charges Women On What To Do

Questions and answers

Dear doctor, thank you for the good job you’re doing for the Nigerian populace. Please, I would like to know what type of ulcer can cause bleeding in stool and the remedies to this problem. I have gone through a series of tests (including endoscopy & colonoscopy) in two general hospitals in Lagos state. Please I want you to recommend a possible solution to this. Thank you. Regards. xxx@xxx.com

Thank you also very much for your kind words. If you had endoscopy done, the cause of such bleeding should be obvious. However, a colonoscopy would have shown if there was something within the large intestine that could also make you bleed. Such bleeding will mix with the stool.

On the other hand, endoscopy is a general term used for all types of scopes employed in looking at the inside of your body. At any rate, I would assume that with the way you referred to it above, you did two such studies to examine your upper gastrointestinal tract which is more appropriate for detecting ulcers and a colonoscopy.

In either case, the cause of any such bleeding would be obvious and treatment offered. The doctors who asked you to carry out these investigations will be best suited to treating you.

Dear doctor, I read your article on umbilical hernia. Can it be corrected in a 20-year-old? I also want you to recommend a good hospital if it can be corrected. Thank you sir.  I’ll appreciate it if you respond to my mail. xxx@xxx.com

Thank you very much for your question. It can be repaired at any age in which it is deemed to be a problem. And any hospital that has a general surgeon within their reach or their employment can treat you for this problem.

Dear doctor, the muscles at the back of my two thighs pull me up to my back region causing me terrible pain after sitting for a long time. Movement there becomes terribly difficult. All the medications I have used have not solved the problem. The x-rays done they say show that the veins are rubbing against the bones. Could it be true? Prescribe your own medication for me please so that I can walk freely again. I am 66 years old and on amlodipine. God bless you as you have been a blessing in disguise for all of us.  0812xxxxxxx

Thank you very much for your prayers. It is not possible for x-rays to determine that some veins are rubbing against any bones and so that is not true. Even if that was the case with you, it should not prevent you from being able to walk properly.

However, my thinking with regards to your problem is that it is a nerve related problem which may have its origin from the low part of your back. For the necessary confirmation, you will need to see an orthopaedic surgeon or a neurologist or both so that the accurate diagnosis can be reached and the proper treatment given to you.

Until this is done, you will probably continue to be told all sorts of tales probably from non-doctors and useful treatment will elude you. As a result of the need to make a diagnosis first, before treatment, it is not possible to get my own prescription as I do not yet know for sure what you are suffering from.

Dear doctor, well done and thanks for your enlightenment all the time. Please, I would like to know implications for a man of between 45 and 50 years who does not have sex for a period of five years for one reason or the other. Thanks. 0803xxxxxxx

There are no health implications sir.

Dear doctor, I am sorry to disturb you. Please, I need your help. I don’t know what to call it but there are some rashes on my calf and my thigh for up to a year now. It neither scratches nor pains me and I have applied many creams but it refuses to clear. What should I do? Thank you sir. 0808xxxxxxx

Thank you very much for your question. You are not disturbing me. Your question is not clear as you refer to one thigh and one calf. Do you mean one calf and one thigh on the same side of the body or are you referring to both calves and the two thighs? Whatever may be the case, you must see your doctor for a proper evaluation.

Let them examine the rashes properly and give you a proper prescription. This is important because even when several types of rashes look alike, they are usually often different and only an expert would be able to treat you in a meaningful way. If your doctors do not succeed in treating it, they would refer you to a dermatologist. Good luck.

READ ALSO: Laparoscopy, Open Surgery Or…? Fertility Expert Enlightens On The Best Medical Procedure To Treat Fibroids

Dear doctor, I have halitosis. How can you help me? 0806xxxxxxx

When you say that you have halitosis, it means you have a clear idea what the problem is. Very often, the cause of this problem is in the mouth and you will greatly benefit from examination and advice from a dental surgeon.

Dear doctor, thanks for your free of charge services every Sunday. I went for an annual checkup and was told I have an enlarged heart. What can I do to bring it to normal and what type of food will you recommend? I am 70 years old and hypertensive. God bless you abundantly. 0803xxxxxxx

I believe that you are taking good care of your health since you mentioned annual health checks. That on its own is a good thing and should help you a great deal to avoid disaster. That said, it is also good to know that if you are hypertensive and have an enlarged heart, it is most probably a result of the high blood pressure.

At your age, it is not likely that your heart can return to its previous state or size. The key options you must adhere to are to take your blood pressure medications religiously and to monitor your blood pressure with such regularity that you must accept that your life depends on it.

Other than those measures, you would need to cut down on your salt intake, quit smoking and alcohol use and perform moderate and regular exercises. Finally, I will say a big Amen to your prayers; you are very kind.

Dear doctor, I am a smoker with erection problems, but after reading your articles, I now know that I have to stop but sincerely speaking, it has become so bad that it cannot stand up for a condom to be worn. Please can you recommend some drugs while I battle with my addition? Thanks for your cooperation. 0807xxxxxxx

The request you have made is not going to be effective for as long as the smoking continues. Besides that, the common medications in use for this malady are well emphasised in the essay on erectile dysfunction.

However, it is not enough to just purchase those medications and use them. You must know which one is best for the kind of problem you have and for that determination to be made, you will have to see a doctor. Erectile dysfunction has various causes and so does its treatment.

Dear doctor, I just read your page on umbilical hernia. Thanks like always for the in-depth analysis. My question relates to frequent sneezing: I have a 12-year-old boy who sneezes up to 50 times a day and has done so since birth. Nothing specifically that I know of triggers this habit. None of his siblings does this or we his parents except on a few occasions. My wife objects to going to the hospital for a checkup on him as she considers it normal. I do not. Is there a cause to worry here? What do I do here, doctor? It is embarrassing to me. Thank you. 0809xxxxxxx

Thank you very much sir. Frequent sneezing as your son has is not normal nor is it usual. Most times, the cause is traceable to an underlying disease condition ranging from contact with physical articles in the environment like bright lights, exposure to cold, having a foreign body stuck inside the nostril or due to things like pepper, orange peelings and onions.

At other times, it is due to an abnormally strong reaction of the immune system to a foreign object and this is known as an allergy. You will have to visit the hospital for him to be properly examined so that the real cause can be determined. It is only then that he can be treated. So, this situation is not normal in any sense.

Article / Source: Dr. Sylvester Ikhisemojie

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