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Pregnancy after removal of uterine fibroids reviews

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Laparoscopic operations firmly occupied their niche in medicine. Good tolerability, fewer complications, a short recovery period are the main advantages of laparoscopy. Pregnancy after laparoscopy of uterine fibroids - one of the most pressing issues that concern women of reproductive age. Like any other surgery on the uterus, the removal of fibroids by laparoscopy may adversely affect the patient's reproductive capabilities. On the other hand, the presence of fibroids can worsen the course of pregnancy. Moreover, a tumor on the uterus can cause infertility and miscarriage.

Definition, classification, causes of development

Myoma is a benign neoplasm, the structural unit of which is smooth muscle fibers that form the muscle layer of the uterus.

Myoma classification is quite extensive. Distinguish manifest and hidden, or asymptomatic form. When complications occur they speak of a complicated course of the disease. Depending on the number of myomatous nodes, the tumor can be single or multiple.

Also in relation to the neoplasm to the membranes of the uterus and given the place of its localization are distinguished:

  • submucosa,
  • intraparietal or intramural formations
  • subperitoneal nodes.

According to the degree of germination in the myometrium, submucosal and subperitoneal nodes are divided into three types:

  • 0 - the node is located completely under the endometrium or peritoneum, does not touch the muscle layer,
  • I - no more than half of the tumor penetrates the myometrium,
  • II - education is more than half, immersed in the myometrium.

With the help of magnetic resonance imaging, it was possible to isolate another type of submucosal neoplasms, in which normal smooth muscle cells are missing between the pathological tissues and the inner lining of the uterus.

Doctors-clinicians use another classification - by the location of the node relative to the axis of the uterus. According to her, myomas are:

  • corporal - located on the body of the uterus,
  • neck,
  • isothermal

The latter type most often provokes the appearance of pain and impaired urination.

The true cause of this nosology has not yet been established, but scientists have identified the main adverse factors. These include:

  • the use of intrauterine devices,
  • abortions,
  • frequent diagnostic curettage
  • childbirth injuries
  • psycho-emotional overload,
  • burdened heredity.

Their influence increases the risk of developing pathology.

Laparoscopy: essence, advantages and disadvantages

The essence of laparoscopy (“bloodless” intervention) is as follows. It is carried out through three small incisions. The laparoscope, the main instrument, is equipped with a video camera with illumination, thanks to which the organs of the abdominal cavity and the small pelvis are visualized. To provide quick access, the abdominal cavity is filled with carbon dioxide, which raises the anterior abdominal wall above the internal organs. This makes it possible to manipulate tools.

Among the advantages of laparoscopy it is necessary to single out a small injury, a short postoperative period, a weak pain syndrome, the absence of large scars, a low probability of the occurrence of postoperative complications, including adhesions. The last point is especially important, since the adhesions in the pelvis are directly related to the patency of the fallopian tubes. The lower the percentage of its occurrence, the greater the chance that the patient is fully rehabilitated and she does not need to re-intervene.

Among the disadvantages of laparoscopy are the essential role played by the need for a specially trained doctor, the high cost of technical equipment, the impossibility of applying the technique in the presence of a tumor of large parameters.

Recovery of the menstrual cycle

For patients of reproductive age who do not have children, the organ-preserving method is a priority treatment method. The physician should make every effort to ensure that the anatomy of the uterus remains as close to natural as possible. If the appendages were healthy and functioned normally, the next menstruation comes in due time. Sometimes a delay is possible. It is considered normal if its duration does not exceed 2-3 weeks.

In the first 6–8 months after laparoscopy, 70% of women manage to become pregnant. At 15% it turns out to conceive a baby by the end of the year. The remaining couples do not have a pregnancy. Then couples are strongly advised to use assisted reproductive technologies, since over time the likelihood of becoming pregnant will decrease independently.

When can you plan a pregnancy

When can I try to get pregnant after laparoscopy of uterine fibroids? This issue is solved taking into account the individual characteristics of the body of each patient. If the education was small and had a narrow leg, pregnancy can be planned within six months after laparoscopy.

In more complex cases, you must wait up to a year. This time is necessary for good wound healing and the formation of a stable scar. It will be able to withstand the stress that the walls of the uterus carry under the influence of a growing fetus. Otherwise, there is a risk of rupture of the uterus. This can happen both in later periods and during childbirth. These situations for the fetus end lethal. In addition, they carry a threat to the life of the mother and, as a rule, end with the removal of the uterus. Of course, after this, conceiving and carrying out the child becomes impossible.

During this period, combined oral contraceptives and regular medical examinations are prescribed. With the help of ultrasound monitor regeneration processes, the formation of the scar, its viability.

Pregnancy planning

When planning a pregnancy, the couple should make every effort to minimize the risk of trouble and increase the chances of successful conception in the shortest possible time. A comprehensive survey should include:

  • clinical and biochemical blood tests,
  • urinalysis,
  • examination for sexually transmitted infections,
  • consultation genetics.

If there are indications, an ultrasound examination of the pelvic organs and mammary glands, colposcopy are prescribed.

In addition, during the pregravidary period, it is recommended:

  • rejection of bad habits,
  • selection of nutrition,
  • taking folic acid and vitamin E.

On request, using the ovulatory tests, you can calculate the days of ovulation: on these days, the chances of getting pregnant are significantly increased.

Conducting pregnancy and childbirth

After removal of myomatous nodes by laparoscopy, gestation of pregnancy, as a rule, proceeds without features. Compliance with medical recommendations will help make it as comfortable as possible. Since after the operation on the uterus there are scars, it is possible full or partial placenta previa, low placentation, pathology of attachment of the placenta, the wrong position of the fetus. Modern diagnostic methods allow you to diagnose these states and plan further tactics.

The mode of delivery mainly depends on the length of the scar and its condition. If the length of the incision did not exceed 3–4 cm, the postoperative period was normal, and, according to the ultrasound data, the state of the myometrium is satisfactory, delivery is carried out naturally. A cesarean section is recommended under such circumstances as:

  • failed scar,
  • the size of the scar is more than 5 cm
  • thinning of the myometrium,
  • pathology of the location of the placenta,
  • suspicion of abnormal attachment of the placenta,
  • malposition.

Is it possible to plan pregnancy with myoma

Many patients refuse to remove the uterine myoma and try to keep the pregnancy in its presence. In such situations, success depends on a few moments.

  • The size of the site, its type and localization. Submucous formations significantly deform the uterine cavity, due to which implantation of embryos and their ontogenesis become impossible. The presence of a thin stalk in a tumor also serves as an indication for surgery — the risk of torsion increases during pregnancy. This requires immediate surgical intervention and threatens the associated abortion. Small intramural or subserous tumors do not interfere with embryo attachment, but may provoke the threat of abortion. According to scientific data, their frequency does not exceed 20%.
  • Propensity for rapid growth - an increase in the tumor more than doubled over the past six months, according to the results of an ultrasound scan, will adversely affect the course of pregnancy.
  • With the size of the uterus, which correspond to 10–12 weeks of pregnancy and more, the planning of the child is undesirable, since there is a very high probability of an involuntary miscarriage.

It is quite difficult to say exactly how a tumor will behave when a pregnancy occurs. About 70% of tumors are reduced in size by about a third. Prolonged breastfeeding also contributes to the development of hypertrophic cells. However, in other cases there is an increase in the tumor. Doctors believe that the main cause of the behavior of the disease depends on the genetic characteristics.

Possible complications of pregnancy with myoma

The presence of a tumor can adversely affect the course of pregnancy. Most often, complications occur in the second and third trimester. The main ones include:

  • threatened miscarriage
  • preterm labor,
  • intrauterine growth retardation,
  • placental insufficiency,
  • torticollis, skull deformity - with a sufficiently large node size.

On the part of the disease are possible:

  • impaired blood supply to the node,
  • torsion legs
  • bleeding,
  • cyst formation.

Recommendations

Laparoscopy may not always be the best method for a particular patient. Despite the fact that the risk of adhesions during abdominal operations is higher, in some cases they are considered the method of choice. Despite the fact that the woman makes the final decision on pregnancy after the removal of fibroids using laparoscopy, she should heed the advice of the doctor. Only together you can find the best way out of this situation.

Is it possible to get pregnant after the removal of uterine fibroids

Uterine fibroids are often diagnosed in women of childbearing age. At the initial stages, doctors try to cure a neoplasm with the help of conservative, mainly hormonal therapy.

But in cases where a benign tumor is growing rapidly and is a threat to the patient's health, surgical removal of the fibroid is the only treatment.

It is at this moment that women who want to have children ask themselves the question: "Is pregnancy possible after the removal of uterine fibroids?"

The influence of pathology on reproductive function

Basically, the tumor is localized in the smooth muscle layer of the reproductive organ, in rare cases, the pathological focus may be located in the cervix. According to medical statistics, more than half of women diagnosed with uterine fibroids have a high chance of becoming pregnant and have to endure the entire period of pregnancy and childbirth without complications.

The success of conception depends on the location and size of the tumor. There are cases when the tumor overlaps the lumen of the fallopian tubes and makes it impossible to attach the ovum in the uterus.

But even if a woman managed to get pregnant, there remains a high probability of her spontaneous interruption at the earliest periods.

It should not be forgotten that during pregnancy a serious hormonal adjustment takes place in the female body, therefore it is almost impossible to predict in advance how the fibroid will behave.

The development of the disease during pregnancy is very unpredictable and ambivalent:

  • In some cases, myomatous nodes under the influence of the changed hormonal background of a woman not only shrink in size, but can also completely dissolve without any medical intervention,
  • The flip side of the medal is the intense uncontrolled growth of a benign tumor under the influence of increased hormone production, which in the future may cause spontaneous abortion.

Therefore, doctors are faced with a very difficult dilemma: to allow the patient to become pregnant with myoma, or to first remove the tumor, and then plan the conception.

In that case, if specialists are inclined to prior surgical intervention, after a full examination, the doctor must choose the optimal method for removing fibroids in each case.

Whether it is possible to get pregnant after the removal of fibroids depends on many factors, so no doctor will give a 100% guarantee.

Fibroid removal methods

Today, there are various methods of myomectomy. Choosing the way to perform surgery, the doctor takes into account the growth rate and size of the node, its localization and other clinically important parameters. The most popular methods of myomectomy are:

  • Hysteroscopic removal - used in women with submucous myoma node. The operation is performed using a hysteroscope through the cervix. This method of removal has clear advantages for those patients who wish to become pregnant in the near future. Surgery is performed under general anesthesia, the duration of uncomplicated surgery rarely exceeds 15 minutes. The tumor can be removed by mechanical, laser, electrosurgical method. The advantages of hysteroscopy - minimal trauma, painless, quick rehabilitation.
  • Laparoscopic removal - used when necessary, a sufficiently large amount of surgical treatment and in cases where there is a question about the complete removal of the genital organ with or without appendages. After laparoscopic removal of myomatous nodes, pregnancy occurs more often than during laparotomy (open removal is more aggressive and traumatic). Among the advantages of this method are the easy and fast postoperative period.
  • Artery embolization method - based on the overlap of the lumen of the vessels feeding the myoma, by introducing into them a special sclerosing substance. Due to the overlap of the lumen of the vascular network, the blood supply to the pathological area is disturbed and subsequent necrotization is observed (tumor dying out). This technique is innovative, therefore it is still too early to judge the consequences and complications. But experts consider the EMA method to be one of the safest for those who want to get pregnant. Patient reviews are mostly positive, therefore, despite the high cost of this procedure, many women choose this method of removal of fibroids.

Complications affecting pregnancy

Despite the fact that most gynecologists insist on the removal of fibroids, even in nulliparous patients, it is worthwhile to carefully weigh all the risks. Of course, the widely used hystero- and laparoscopic operations are low-traumatic and do not pose a threat to life, but at the same time they do not give a full guarantee that a woman can have children in the future.

Any surgery can adversely affect future pregnancies.

Therefore, when it will be possible to plan conception, determines only the attending physician.

Possible complications:

  • ectopic pregnancy,
  • spontaneous abortions at different stages of pregnancy,
  • formation of adhesions,
  • disease recurrence
  • massive uterine bleeding during childbirth,
  • damage to the uterus during childbirth in the postoperative scar (up to the organ rupture),
  • abnormalities of the fetus associated with impaired trophism of the uterus due to nodules.

Rehabilitation period

In order to increase the chance of getting pregnant and giving birth to a healthy baby after a conservative myomectomy, a woman must responsibly follow the rules of rehabilitation.

Postoperative recommendations:

  1. In the first days it is necessary to follow a therapeutic diet. The use of foods rich in fiber - the first prevention of constipation,
  2. Completely exclude physical activity, giving the load on the pelvic organs and the abdominal cavity,
  3. Be sure to wear at least a month specialized, properly selected band size,
  4. It is advisable to engage in groups of exercise therapy.

It is important to regularly visit a gynecologist, who will monitor the state of the pelvic organs and the abdominal cavity, and help plan the pregnancy after the treatment of uterine fibroids.

Chances of conception after removal of fibroids

The ability to become pregnant after the removal of fibroids is directly dependent on the amount of surgical treatment produced.

Also important is the state of the reproductive system and the hormonal background of the woman, both in the early and late postoperative periods.

Strict adherence to the prescriptions and recommendations of the attending physician will help to plan the pregnancy after myomectomy and give birth to a healthy baby.

После успешно проведенного оперативного лечения миомы шансы забеременеть достаточно велики. Но важно не только зачать, но и выносить ребенка.

Чтобы беременность и роды прошли без осложнений, врачи рекомендуют планировать зачатие не ранее чем через год после хирургического удаления миомы, а после сложной полосной операции можно беременеть только спустя 2 года.

Maternity after the removal of fibroids is quite real, more than 50% of treated women successfully give birth to healthy children.

Patient Reviews

Marina, 36 years old

A few years ago, they diagnosed uterine fibroids. The sizes were small, so she did not agree to surgical treatment. Over 2 years the tumor grew by 3 cm.

All this time my husband and I tried to conceive a child - unsuccessfully. Completely desperate, then I agreed to the operation, which was performed by laparoscopic method. 5 months have passed, there are no new nodes.

In six months we will try to conceive a baby. I hope everything will work out.

Catherine, 30 years old

At 28 years of age, several small knots were discovered on the uterus. Before trying to get pregnant, but to no avail.

For all the time there was one pregnancy that ended in miscarriage, after that nothing worked. In the end, I decided to hysteroscopic removal of the tumor. After 2 years, we had a beautiful girl.

Many thanks to the doctors for explaining everything in detail and advising them not to delay treatment.

Pregnancy after removal of uterine fibroids: possible or not

Gynecological diseases affect the reproductive function of women. The most dangerous tumors that are removed. Uterine fibroids is a pathological neoplasm, the treatment of which often involves surgical intervention. Women of childbearing age are concerned about whether they can become pregnant after the removal of uterine fibroids.

Impact of operation on childbearing function

Treatment of uterine fibroids can be carried out conservatively, but often the patient is shown surgery to eliminate the tumor formation. After removal of the fibroids, the reproductive function is impaired. But depending on the type of surgery, the problem may be temporary or permanent.

When using gentle methods of treatment, only the tumor itself is removed, or part of the tissues of the organ together with the myoma node.

In this case, the reproductive organs continue to function normally after recovery. Only when the organ itself (uterus) is removed is the diagnosis “infertility”.

In other cases, the possibility of conception, according to statistics, remains in 85% of women. The remaining 15% include patients with complications.

Hysteroscopy

Modern way to remove myomatical neoplasms - hysteroscopy. This method is used for diagnostic examination, as well as for surgical purposes. Hysteroscopy is the least traumatic for the female body.

The advantages of hysteroscopy is the absence of tissue incisions and a long rehabilitation period. In the future, pregnancy after the removal of uterine fibroids by this method may occur within two months.

Hysteroscopy is used in the diagnosis of very small tumors that are on the surface of the tissues inside the cavity of an organ. Hysteroscopy is not recommended for all patients, as it has multiple contraindications.

Myomectomy

In the presence of larger nodes or multiple neoplasms, myomectomy is indicated. Myomectomy can be performed by the two previous methods (hysteroscopy and laparotomy), however, surgery involves a more complex operation.

After myomectomy, the patient may become pregnant, but rehabilitation takes at least a year. This is due to the tramatization of the tissues of the organ, as a result of which, with subsequent pregnancy, there is a risk of complications (incorrect position of the fetus, deterioration, etc.). Myomectomy can also be performed by abdominal surgery.

The appointment of abdominal surgery occurs in the presence of complications. The abdominal method involves making an incision in the uterus or completely removing it. When the organ is preserved, the woman has a greater chance of getting pregnant.

Abdominal myoma surgery

The cavity method is the most traumatic, for this reason it is recommended to plan a pregnancy no earlier than one year later. Before the planned conception, a woman should check the condition of the sutures on the uterus, since the elasticity of the tissues due to the presence of scars is much lower and pregnancy can cause serious complications.

Rehabilitation

The method of surgical intervention affects the duration of the rehabilitation period. Rehabilitation after hysteroscopy is much faster. The functionality of the organs is restored within one month. After laparoscopy, full rehabilitation can last up to two months. As a rule, there are no complications during the rehabilitation period.

The most difficult is rehabilitation after abdominal surgery. Tissue injury, suturing and direct damage to the organ leads to painful sensations for a long time. The uterus itself is also restored for a long time. It takes about ten days to heal the incision, but it takes about 1 month to fully restore.

During the rehabilitation period, a woman is recommended:

  • monitor changes in your condition,
  • periodically undergo an ultrasound examination,
  • take hormonal drugs
  • drink a course of drugs to prevent inflammation and tumor recurrence.

During the rehabilitation, the restoration of the menstrual cycle takes place, which is important for conception.

Can pregnancy occur after removal of myoma with conservative myomectomy or laparoscopy

There are several ways to remove uterine fibroids. Each operation has its own characteristics and ways to remove a tumor in the uterus. Can I get pregnant after myomectomy and after how much?

Myoma is a benign tumor that can be in single or plural form.

35% of the female population has uterine fibroids.

She is weighing from a few milligrams to tens of kilograms, so women at the initial stage of tumor development are not aware of the presence of the disease.

When arises

This benign formation has many reasons for occurrence, the main ones are:

  • heredity,
  • hormonal disruptions.

Often, fibroids occur in women due to heredity. If the grandmother, mother had such a problem, most likely, the daughter will also have it.

Hormonal failure happens for a variety of reasons. Stress, a sharp weight gain or a strong weight loss affects the excessive production of estrogen, which is the causative agent for the appearance of tumor cells. The chance of the appearance of fibroids in obese women increases, since estrogen is produced by fat cells, too.

A very important role is played by the quality of sex. During intimacy, blood rushes to the pelvic organs. When reaching orgasm, the blood drains back for a few minutes.

How is it treated?

There is a medical and surgical treatment. The treatment of fibroids using the drug method is carried out if the woman is of childbearing age, the tumor does not grow and is small. They try to resort to surgical intervention only in rare cases when it is necessary:

  • large size of fibroids in the uterus,
  • fast growing tumor
  • strong blood loss during menstruation, which leads to anemia,
  • abnormal nutrition of myoma node,
  • squeezing of the pelvic organs,
  • growing fibroids in the cervix (present in 1% of patients with myoma).

Pregnancy after removal of fibroids - is it possible

If the tumor was removed locally, after a while you can conceive and carry out a healthy child. But if it was decided to remove the entire uterus, the woman becomes infertile. There are several options for surgery that are used to remove uterine fibroids.

Two or three small cuts are made. One incision for the laparoscope (thin tube with a camera and illumination), the second for the instrument. The operation is complex technically and requires great accuracy. Laparoscopy is also called "bloodless" intervention.

This method of operation is less damaging to the uterus, which is very important if there are plans to become pregnant. Only the doctor will tell you how long you need to wait with conception. If the education was small, you can become pregnant within six months. With a more complex operation, you need to wait at least a year.

Invasive removal and pregnancy

You can remove uterine myoma in several ways.

  1. Open lane operation. It happens the same way as cesarean section. Most often it is done on the skin fold 2.5 cm above the pubis. With pregnancy after such an operation, you need to wait at least a year, since the incision in the uterus must completely heal.
  2. Robotic myomectomy. The principle is the same as with laparoscopy. The only difference is that the surgeon controls the instruments not with his own hands, but through a special console.
  3. Hysteroscopic myomectomy. Removal of fibroids occurs through the vagina. A special instrument, the resectoscope, is inserted inside. During the operation, he uses an alternating high-frequency current or laser beam. This operation is done in the case of submucous fibroids (when the tumor grows inside the uterus).

Pregnancy after conservative myomectomy

If you figure out what the term "conservative myomectomy" means, you get: "conservo" - save. Hence, this is a type of operation in which the uterus is not removed, and only myoma nodes are eliminated.

In the further planning of pregnancy, the role is played by how the fibroid was removed, how large the tumor was, and where it was located.

The doctor advises the patient, explaining when it will be possible to become pregnant, and for what reasons it can not be done earlier.

Can I get pregnant after uterine fibroids

If the tumor makes it difficult to get pregnant, and medical treatment is not suitable, it is necessary to remove it surgically. After some time, you can conceive a child, if during the operation the appendages were not removed.

In no case can not become pregnant immediately after surgery. When removing a benign lesion, cuts and stitches were made. During pregnancy, a growing baby severely stretches the uterus, which is why fresh stitches will immediately diverge. This will result in loss of the fetus, re-operation and a course of recovery.

Through how much can

Depending on the complexity of the operation, the doctor says how long it is impossible to get pregnant. Often, it is from six months to one and a half.

The scar on the uterus must heal. If the connective tissue is from muscle cells, then the uterus is ready for the onset of pregnancy. Otherwise, there is a chance of seam divergence. The doctor will check the condition of the suture and tell you when the woman is ready to bear the fetus.

Probable complications

In all, the rehabilitation period is different. Some quickly come back to normal, others suffer pain for some time.

There are certain rules that a woman must adhere to so that new myomatous nodes will not appear.

Recovery after surgery occurs with the help of medication, and at this time it is necessary to exclude alcohol. Clothing should be comfortable, not squeeze the seams so that they do not become inflamed.

How is pregnancy going after fibroids?

If the recommendations for recovery after surgery are followed, the suture on the uterus healed, and there are no contraindications to pregnancy, then it is possible to conceive a child.

A woman in the position after myomectomy is constantly observed by a doctor, but, in fact, carrying a child after the operation has nothing to do with normal pregnancy.

Surgery to remove a tumor in the uterus is the only chance to get pregnant.

Sometimes the tumor becomes so large that it overlaps the fallopian tubes and the entrance to the uterus, because of which the egg does not fertilize or is not fixed in the uterus.

Before you get pregnant after myomectomy, you should wait some time. Constantly consulting with the doctor, he will tell you when the uterus is ready to bear the baby.

The effect of fibroids on pregnancy

Statistics show that about 4% of pregnancies occur on the background of uterine fibroids. The presence of knots does not mean that a woman cannot become pregnant or bear a healthy child. However, the nodes can interfere with the implantation of a fertilized egg in the uterus wall, causing complications in the development of the fetus and in the process of delivery.

Myoma is not a definite factor of infertility, but can cause it. Infertility and recurrent miscarriage are often caused by many additional factors:

  • Congenital and acquired pathologies of the reproductive system (in addition to myomatous nodes),
  • The inflammatory process in the reproductive organs,
  • Adhesions,
  • Uterine injuries as a result of surgical interventions, abortions, scraping,
  • Hormonal disorders
  • Genetic abnormalities
  • Psychological infertility
  • Infertility of unknown etiology.

Treatment of myomatous tumors is included in the list of recommended measures in the process of infertility therapy, however, this does not guarantee a safe pregnancy if the problem was not in the myoma. Therefore, the elimination of infertility requires an integrated approach, with a comprehensive survey of women and men.

Myomatous nodes do not always need to be removed before pregnancy. In some cases, uterine fibroids may even be treated with pregnancy, since the nodes regress in 8-27% of cases.

Small-sized neoplasms begin to decrease due to changes in the hormonal background. For the same reason, their growth is observed in 22-32% of cases. Predict the behavior of the pathology can only be qualified gynecologist.

The doctor will prescribe a woman a series of studies, based on which determines the feasibility of treatment of myoma nodes during pregnancy.

Complications of pregnancy with myoma occur in 10-40% of cases. The most common of these include:

  • Abortion,
  • Pathology of the fetus,
  • Rupture of fetal membranes,
  • Preterm labor
  • Postpartum bleeding.

The most dangerous for the fetus are large submucous and intramural nodes located behind the placenta. If there is a high risk of complications, the doctor may recommend pregnancy after removal of the fibroids with laparoscopy. Reviews of minimally invasive operations, mostly positive.

Such surgical interventions are gentle to the tissues of the uterus. Embolization of uterine arteries is considered the safest among minimally invasive methods of treatment.

During the procedure, the uterus is not subjected to mechanical stress, and the nodes regress gradually, leaving no scars or other injuries.

Features and risks of pregnancy after removal of fibroids

The danger of the removal of nodes in the uterus is that under the surgical influence of the tissue of the reproductive organ can be deformed. This leads either to the impossibility of becoming pregnant, or to complications in the process of carrying a child and childbirth.

Removal of fibroids during pregnancy should be for good reason. Surgery to remove fibroids during pregnancy is fraught with a great risk of harming the fetus and mother, and therefore must have good reasons.

Such intervention can be recommended if there is an intensive growth of nodes and their absolute negative impact on the condition of the woman and the fetus.

Removal of fibroids prior to planned conception may be recommended in the following cases:

  • Observed multiple nodes of medium size,
  • There is a growth of nodes
  • Neoplasms grow in the direction of the uterus,
  • Reproductive history shows that neoplasms can cause infertility.

There are two main methods of treatment of this pathology: drug and surgical. The first is shown in the case when the nodes are small and their intensive growth is not noted. This method cannot be applied in the cases listed above, since it will not be effective for them. That is, the second method will be recommended to the woman - surgical.

Here, a choice is usually made between myomectomy and uterine artery embolization. Myomectomy can be performed by laparoscopic or open (abdominal) access.

The latter is used in modern gynecology extremely rarely in particularly complex and emergency situations. Laparoscopy is a minimally invasive intervention that allows you to remove all visible nodes.

Pregnancy after removal of uterine fibroids by laparoscopic method will have the following risks:

  • Relapse of pathology due to the growth of nodes that were hidden from the surgeon,
  • The development of adhesions,
  • The presence of scars after the removal of large nodes that can disrupt the structure of the tissues of the uterus.

Women planning a pregnancy after the removal of fibroids, members of the expert council of our site recommend to prefer embolization of the uterine arteries.

This method allows you to remove all the nodes at the same time - both large and small (still emerging), which eliminates the risk of pathology recurrence. After the procedure, there is no scarring or other damage to the uterus, that is, its tissues remain unchanged.

The likelihood of developing postoperative complications after uterine artery embolization is significantly lower than after myomectomy. Also, after embolization, recovery is much faster.

Pregnancy after removal of fibroids - when to plan, the probability of conception

Pregnancy after removal of fibroids occurs with a probability of 85%. It is very important to undergo a complete examination of the body before planning a pregnancy, and begin timely treatment. Благополучно проведенная операция позволяет женщине насладиться материнством, ощутить себя счастливой.

Миома матки и зачатие

Наличие новообразования в полости детородного органа не влияет на развитие яйцеклетки, овуляцию, оплодотворение. Но препятствует закреплению яйцеклетки к полости матки. Вероятность наступления беременности зависит от некоторых факторов.

  1. Локализация. A myomatous node may form in the uterine cavity, on its neck. If the localization of a neoplasm deforms the cavity of the reproductive organ in the place where the egg cell moves, is attached to the walls, pregnancy is impossible for physiological reasons. In other words, myoma does not allow a fertilized egg to attach after conception. In addition, the presence of fibroids changes the structure of the endometrium, which also reduces the likelihood of pregnancy.
  2. The size. A slight increase in myoma nodes, their location outside the cervix, does not prevent the development of pregnancy. A large tumor reduces the probability of pregnancy by 60%, and in the case of its occurrence it does not guarantee the full development of the fetus. The presence of a neoplasm in the uterus violates the nutrition of the fetus, prevents normal physical development. Major fibroids and pregnancy - incompatible things. Moreover, myoma provokes miscarriages at any stage of pregnancy.
  3. The upward trend. The true nature of the development of fibroids remains unexplained until now. A tumor has been able to remain in a constant position for a long time, without causing any special difficulties. Under such conditions, along with myoma, the fetus can fully develop. The danger is that under the influence of hormones, growth of the neoplasm is activated. No doctor will give a guarantee how myoma will behave during pregnancy. A direct contraindication to conception planning is tumor growth in the last 6 months.

Myoma can occur at any age, for a long time not to be felt. In most cases, it is detected at random at a gynecologist's appointment.

Moreover, the tumor is prone to self-extinction without any treatment. A woman can plan a pregnancy without knowing her problem.

Therefore, experts recommend to undergo a preliminary examination when there is a desire to become a mother.

Removal of fibroids when planning pregnancy

Small-sized neoplasm is treated with medication, including hormones. If this treatment option does not give the desired effect, recommend surgery. A woman finds herself in a difficult situation.

On the one hand, fibroids will not allow pregnancy to develop fully, interfere with conception. On the other hand, the operation can cause problems with conception. And in the process of carrying a fetus seams can disperse. In case of unavoidable surgery, it is necessary to take seriously the choice of a clinic, a surgeon.

Since masterfully sewn seam increases the likelihood of conception and successful pregnancy.

One of the indications for removal of fibroids surgically is the inability to get pregnant, the risk of miscarriage. The method is chosen based on the size of the tumor. Myoma is classified as follows:

  • Small - 2 cm, corresponds to 5 weeks of pregnancy,
  • Average - up to 6 cm, 10 weeks,
  • Large - over 6 cm, size corresponds to a 12-week period,
  • Giant - The uterus increases to the size of a 16-week pregnancy, more.

Currently, there are several methods of surgical removal of neoplasms:

  1. Abdominal surgery. It is used extremely rarely if other options are unacceptable. The indication for abdominal surgery is the twisting of the leg of the tumor, necrotic processes in the nodes.
  2. Laparoscopy. One of the most preferred methods to remove a neoplasm when planning a pregnancy. It involves the conduct of surgical manipulations by several punctures of the abdominal cavity. For a week the patient is in a state of disability, wounds heal quickly, do not leave any characteristic marks. The method is considered low-impact, does not provoke the formation of adhesions. It is used if the size of the fibroids does not exceed 1 cm, and the number of nodes is no more than 4. The total diameter of the numerous fibroids should not be more than 1.5 cm.
  3. Laparatomy. Removal of nodes is carried out through a small incision in the abdominal cavity. The indications for using the method are the large sizes of fibroids, growth in the abdominal cavity, the region of the pelvic organs. The rehabilitation period is about a month, the risk of formation of adhesive processes increases.
  4. Hysterectomy. It is considered a radical method of surgical intervention. Used in extreme cases, involves removal of the entire uterine body.
  5. Hysteroscopy or myomectomy. Conducted on an outpatient basis, is used for a single myoma, located on the front wall, the bottom of the uterus. A hysteroscope is inserted into the uterine cavity by intravaginal route. The operation is well tolerated, does not require long-term rehabilitation.

Alternative methods of removing fibroids when planning pregnancy are:

  1. Laser. The operation is carried out strictly dosed by a laser beam. Removes only the tumor, does not affect healthy tissue. The patient does not lose blood, no scars remain at the site of exposure. The rehabilitation period does not exceed 3 days.
  2. Uterine artery embolization. Costly procedure with an efficiency of 98%. It is performed under local anesthesia. A catheter is inserted into the uterus through the femoral artery, and a solution of polyvinyl alcohol is directed through it. The substance clogs blood vessels, closes the power, blood flow in myomatous nodes. Myoma shrivels, dies.
  3. FUS ablation. Removal of nodes occurs due to the effect of ultrasound waves under the control of MRI, without compromising the integrity of the tissues. Strictly directed waves cause evaporation of fluid in the nodes, cause cellular destruction. The procedure is carried out with myoma of medium size - 2-9 cm, localized on the mother bottom, the front wall. The method is not recommended for unrealized fertility, as it often provokes a violation of the cycle, tumors with the leg.

Alternative methods for removal of fibroids are costly, effective, but the effects after surgery are not fully understood. This is the main problem when planning conception.

Pregnancy after surgery

The probability of a successful conception after surgery depends on the individual characteristics of the organism, the size of the fibroids, side effects, and the well-being of the procedure. Regardless of the method, planning can begin no earlier than 8 months. The ideal option is considered a year after removal.

Pregnancy after laparascopy

The procedure is less traumatic, does not provide for long-term rehabilitation. However, the pregnancy will have to wait a bit. In the uterus, strong, strong scars should form at the site of fibroids removal. To establish their work should the ovaries. Experts recommend planning conception after 6 months, or even a year after laparoscopy.

Pregnancy before this time can cause seam divergence, rupture of the uterus along the scar, as a result of which the organ will have to be removed. The probability of conception 6 months after surgery is 85%. During rehabilitation, a woman is recommended to take hormonal drugs to normalize hormonal levels, activate reproductive functions.

Pregnancy after abdominal removal

To carry out this method requires a good reason, because they resort to it in particularly severe cases. This suggests that before the operation, the reproductive system had suffered significantly, the menstrual cycle had changed.

It takes time to recuperate after surgery, scar healing, as well as to normalize the menstrual cycle. It is recommended to start trying to get pregnant one year after the surgery.

The chances of a successful intervention are 85%.

Pregnancy after embolization of the arteries

The method is considered highly effective, with minimal rehabilitation time. However, it is not fully understood the consequences of surgical intervention, the effect on the reproductive system.

Immediately after the operation, the woman feels pain in the lower abdomen, which lasts about 2 hours. 5% of women after surgery develops amenorrhea, with a long absence of menstruation. Doctors recommend planning a pregnancy after six months.

However, the individual characteristics of the organism, the well-being of the operation are taken into account.

Postoperative period

How quickly the body returns to normal depends on the method of removing fibroids. If he does not provide for the violation of the integrity of tissues, everything happens much faster.

The first time after the operation, the woman feels nauseous, weak, pain in the abdomen - the effects of anesthesia. A few days will be felt discomfort, fatigue. After abdominal removal of the uterus, the woman spends at least a week in the hospital.

Assign hormonal drugs, painkillers, anti-inflammatory, etc. Individual treatment in each case.

At home, a woman should not overwork, lift weights. Give more time to sleep, rest, walks in the fresh air, proper nutrition. A successful operation allows a woman to become pregnant and have a baby safely. Moreover, after the removal of small fibroids to give birth is permitted naturally.

When can I get pregnant after removing uterine fibroids?

Uterine fibroids - one of the most common pathologies in the field of gynecology. Despite its benign nature, this phenomenon can pose a serious danger to the health of the woman, so she needs active therapy, and in more serious cases, surgery is performed to remove the tumor.

When to plan a pregnancy after an EMA?

It should immediately be noted that uterine embolization in no way affects the reproductive functions of the female body. This is a procedure that hundreds of women go through annually, and most of them give birth to full-term and completely healthy babies after a while. Fibroids can be removed in many ways, but cases where difficulties have occurred with the subsequent fertilization of an egg in medical practice are very rare.

When can you become pregnant after removing fibroids? It is difficult to give an unequivocal answer, because each patient has their own individual characteristics of the organism, which cannot be ignored in this situation. Since the carrying of the fetus is a very serious matter, it must be approached with responsibility, without neglecting even the most insignificant, at first glance, nuances.

Gynecologists believe that. ... after the treatment of the disease, no matter how it is implemented, it should take at least 9 months before the woman decides to become pregnant. During this time, the walls of the uterus will have time to fully recover, and the organ itself will get stronger after the operation, which for him is the strongest stress, as well as for the entire female body.

But sometimes for complete regeneration of the tissues of the walls of the uterus may take longer. This happens if the fibroid was multiple and struck a significant part of the cavity of the reproductive organ. Doctors may recommend postponing pregnancy planning from 12 to 15 months. This is done in order to be able to evaluate the effectiveness of rehabilitation therapy, which consists in taking vitamin complexes and performing certain physical exercises. When the treatment is over, you need to see a doctor and be examined.

Under what conditions myoma and pregnancy are compatible concepts?

The presence of a benign neoplasm in the uterus is not a sentence, and a full-fledged fetus is possible if:

  1. The tumor is not located directly on the walls of the reproductive organ.
  2. Myoma has non-critical dimensions that will not pressure the placenta.
  3. The uterus has no other pathologies anymore.

Of course, any nodes, even if they are benign, can seriously affect the pregnancy, which is why it is necessary to remove them before the woman decided to become pregnant.

What are the complications of surgery?

Pregnancy after suffering the removal of the tumor is impossible in 2 cases:

  1. Knots located in the uterus prevent attachment to the walls of the ovum.
  2. The neoplasm blocks the path of sperm into the fallopian tubes, as a result of which the seminal fluid cannot reach the egg and its fertilization does not occur.

Many patients experience how, and can they even become pregnant after the removal of uterine fibroids? The doctors on this score are unanimous: if all the favorable conditions are created for fertilization, then you can become pregnant both naturally and with the help of IVF.

However, there are several comorbidities that adversely affect pregnancy and its outcome:

  • Endometriosis.
  • Polycystic ovary.
  • Endometrial polyps.

If the pregnancy has already begun, and only then the expectant mother learned of the presence of the disease, then you must first be registered with a gynecologist. Only he will be able to decide on the elimination of fibroids, if any.

Possible complications after EMA can be:

  1. spontaneous abortion (miscarriage),
  2. preterm labor,
  3. fetal hypotrophy,
  4. umbilical cord damage,
  5. the discovery of postpartum hemorrhage,
  6. damage to the placenta
  7. difficult childbirth.

It is for these reasons that pregnancy after the removal of fibroids should be planned carefully with the obligatory consultation of the doctor.

Although removal of a neoplasm with the help of EMA is considered the safest procedure, it also has its own risks, nuances and contraindications. It can be performed only in the case when there is no likelihood of opening heavy bleeding. If the patient has a bad blood clot, then any surgical intervention can lead to the fact that you will not be able to get pregnant, and in some cases it is even fatal.

Childbirth after surgery: caesarean or delivery by natural means?

Getting pregnant after removing fibroids, according to doctors, is not a problem, and even those women who are afraid of complications can consider themselves to be absolutely safe. However, many expectant mothers are worried about another important question: what kind of childbirth can be considered safe - natural, or with the help of a surgical intervention (by performing a cesarean section)?

Indeed, this is a very important decision for any woman who has undergone removal of uterine fibroids. As a rule, after this manipulation, the patient's body recovers fairly quickly, without requiring additional courses of therapy. But if you still want to play it safe, so that the pregnancy proceeds safely and without complications, then you can take special vitamins for several months before planning it.

If after the operation there are no complications, then you can safely decide on natural childbirth - they will not harm either you or the baby. A caesarean section is used exclusively in extreme cases when multiple nodes have been found in the uterus. They can put pressure on the fetus and placenta, which can later lead to a disruption of its normal and full functioning.

After removal of a tumor in a caesarean section, almost never a need arises; therefore, women are able to bear and give birth to a baby on their own. Natural childbirth has a positive effect on the complete recovery of the body after surgery, and in some cases even prevent the recurrence of uterine fibroids.

Possible complications of pregnancy after removal of uterine fibroids

Some pathologies of the pelvic organs can adversely affect the reproductive function of the expectant mother, in particular, and myomatous tumors. What is the course of pregnancy after removal of fibroids, and why complications can occur?

What types of surgery are used?

When uterine fibroids cannot be eliminated with the help of drug therapy, the tumor can be removed by a doctor with the help of an operation. This is done by means of the hysteroscopic, laparoscopic method, vascular embolization, and ordinary abdominal surgery. Each of these methods has its own characteristics and influence on the reproductive function of women.

Hysteroscopy is one of the safest ways to remove uterine fibroids for a woman who wants to have a baby in the future. The doctor does not make any incisions; penetration into the uterus is made through the vagina.

Removal can be performed electrically, laser or mechanically without opening the uterus. The operation takes about 15 minutes, does not leave scars on the uterus, patients recover quickly enough.

Laparoscopy is also safe for future mummies, as it allows preserving the genital function in full. After therapy, a woman is rehabilitated in a short time, approximately six months later she is able to plan for the birth of a child.

Another method used to remove uterine fibroids as embolization of blood vessels, which provide the reproductive organ with nutrition. With this treatment, the vessels feeding the neoplasm overlap, with the result that the tumor gradually decreases and eventually dies off. This method is the most harmless to women planning a future pregnancy.

In some cases, patients have to settle for abdominal surgery to remove uterine fibroids. Это может быть сделано только в особо тяжелых случаях. После такого оперативного вмешательства детородный орган приобретает рубцы, происходит сбой менструального цикла.

Пациентке требуется довольно длительное время, что бы полностью реабилитироваться. Беременность после миомэктомии такого типа возможна не раньше чем через год. Вероятность зачатия очень высокая, но вынашивание ребенка может осложниться, так как на матке имеются рубцы.

Можно ли забеременеть после терапии?

Can I get pregnant after removing fibroids? Thanks to modern medical methods, it has become possible to preserve the fertility function in women. The main thing is that further after the operation there will be no complications that would prevent conception and carrying the baby.

After surgery, the following risks are possible:

  • The formation of adhesions that can prevent a woman from normally carrying a child.
  • Repeated development of uterine fibroids. No operation can guarantee that over time the pathology will not reappear. This happens not so often, but still there is a possibility. This can complicate the conception and carrying a baby.
  • The appearance of scars on the walls of the uterus and bleeding. Scars can occur during abdominal surgery. This results in the development of an ectopic pregnancy after the removal of fibroids, spontaneous abortion.

The most important and dangerous sign for future pregnancy after fibroids is scar formation.

The forecast regarding the favorableness of carrying a child is made depending on how much such damage is on the uterus, whether the reproductive organ itself was opened, whether the scar can grow before the baby is born. It depends on all these factors whether the woman carries the child after the operation or not.

Diseases of the placenta

If a woman has a scar on the wall of the uterus after the operation, then a serious obstacle to the normal attachment of the placenta is created. A fruit egg cannot find the most favorable place for itself, therefore it has to be attached in a not very convenient place.

If the fertilized egg stops its choice of place on the lower region of the reproductive organ, then the woman will have a complete placenta previa, and the likelihood that hemorrhages will disturb the baby will increase. With such a diagnosis, a pregnant woman will not be able to give birth on her own, so a cesarean section is prescribed.

If the placenta is located directly on the scar of the uterus, then placental insufficiency occurs. As a result of this, the blood circulation of the reproductive organ is disrupted, thereby impairing the activity of the fetal place. This leads to the fact that the baby does not receive enough nutrients and oxygen.

When the fetus does not fully provide oxygen, there is a violation of intrauterine development of the child’s brain. And if the baby does not receive the necessary vitamins, then a delay in the physical development of the crumbs is possible. After the baby is born, a variety of failures in the body of the child are guaranteed.

The occurrence of uterine rupture

Another rather dangerous condition of the woman, when she became pregnant after the removal of uterine fibroids, is the rupture of the organ to the place where the scar passes. This can occur both during gestation and during labor.

The uterus may rupture due to the fact that the scar is very weak and does not withstand strong stretching. When a rupture approaches during pregnancy after laparoscopy of fibroids, the woman will experience the following symptoms:

  • Nausea and vomiting.
  • Soreness in the abdomen, giving to other areas of the body.
  • Muscle tension of the reproductive organ.
  • Blood discharge from the vagina.

If the uterine rupture has already occurred, then there are also signs such as:

  • The rapid deterioration of the general condition of women.
  • Dizziness.
  • Low blood pressure.
  • Increased heart beat.
  • Killed breath.
  • Pallor of the skin.

When the uterus ruptures, a lot of blood goes into the abdominal cavity, fetal hypoxia occurs, the baby’s condition worsens. In this case, urgent medical care is important.

If the uterus began to rupture directly during labor, the following manifestations are noticeable:

  • Nausea, vomiting.
  • Pain syndrome.
  • Weakness.
  • Increased pain during labor.
  • Bad progress of the baby, despite the full disclosure of the uterine cervix.

Also added is an overstrain of the muscles of the uterus, the appearance of blood discharge from the vagina. The rupture of the reproductive organ occurs almost immediately after the onset of these symptoms. Therefore, it is necessary to urgently provide medical care, otherwise the pregnant woman and the baby may die.

How is planned and being re-pregnancy?

After how much time you can get pregnant, decides the attending physician. Before conceiving, be sure to check your body well, so that in the future there will be no problems with gestation and childbirth.

If a woman becomes pregnant, it is necessary to register as early as possible, no later than 12 weeks. In the process of carrying it is necessary to undergo an examination. Ultrasound is considered one of the most important.

It allows you to identify signs of insolvency scar on the wall of the uterus, namely, to determine whether its contours are intermittent, whether the muscles of the reproductive organ are thinned, whether there are particles of connective tissue in the rumen.

If an insignificant uterine scar is revealed, then women will not be allowed to give birth on their own. In this case, only cesarean section is shown. Otherwise, natural childbirth after myomectomy can cause a rupture of this damage, the formation of bleeding, the death of the laboring woman and the child itself.

If a full-fledged scar is detected, the doctor may allow to give birth on his own, but only under the following conditions:

  • Head presentation of the fetus.
  • The same size of the head of the baby and the pelvic part of the pregnant.
  • Finding the placenta outside the rumen.
  • The absence of negative consequences of carrying a child.

In the case when myomectomy of the uterus is performed directly during the carrying of the baby, the woman will give birth exclusively by cesarean section. If in the course of natural childbirth with a full-fledged scar, complications have suddenly arisen or the condition of the baby has worsened, then emergency assistance is provided through a cesarean section.

Uterine fibroids during pregnancy

Quite often, women in reproductive age have questions that relate to the possibility of pregnancy with uterine myoma or after surgery to remove it. It is very important to make the right decision about the tactics of each individual patient. Are uterine fibroids and pregnancy compatible?

Myoma is a benign tumor composed of muscle tissue.

It occurs when the muscle cells of the uterus actively begin to divide. Doctors have not fully clarified why this is happening, but the most likely cause is called hormonal stimulation and increased secretion of estrogen. Back to content

Is it possible to get pregnant with uterine myoma?

The answer to this question depends on many factors that should be considered:

  • Myoma node localization

If the myoma node is localized in the cavity or wall of the uterus in such a way that the cavity is deformed, or on the cervix, then pregnancy is impossible physiologically. The nodes of this arrangement act as a spiral, are a kind of contraceptive. Spermatozoa simply remain on the surface of these nodes and do not reach the fallopian tubes. Therefore, the egg and sperm are not found. Such nodes should be removed!

With small size of myoma nodes and located in the uterus wall itself or outside (subserous localization), in the absence of deformity of the cavity, pregnancy under other satisfactory conditions may occur. In the case of the nodes described, pregnancy can be planned. In the future, problems are still possible, they may be associated with carrying, but their frequency according to statistics is about 15-20%.

If there is a knot with a thin leg, during pregnancy there is a risk of torsion, this will lead to emergency surgical intervention and possible interruption. If you are preparing to become a mother, these nodes should be removed beforehand.

If, according to the results of ultrasound and observations, fibroids grow rapidly, i.e. increases in size by 1.5-2 times in the period of six months, then planning for pregnancy with uterine myoma is impossible. In this case, there is a high risk of fibroid growth during gestation, there is a possibility of a malfunction in the nutrition of the myoma node, and the risk of miscarriage increases. In this case, you must first carry out surgical treatment.

If the fibroid is large (the size of the uterus exceeds 10-12 weeks of pregnancy, and in the case of IVF with fibroids more than 4 cm), you should not plan a pregnancy, there is a high probability of miscarriage and the appearance of malnutrition during gestation, which can lead to emergency surgery . And the occurrence of pregnancy in this case is unlikely, because in 60-70% of these patients endometrial pathology occurs, which makes it impossible to implant the embryo.

Does uterine fibroids grow during pregnancy? Predicting the "behavior" of fibroids during this period is not possible. This is a genetically determined factor. According to statistics, 65-75% of nodes are reduced by about 30%, but 25-35% of myomas can grow during pregnancy, very rapidly, and, as a rule, the increase occurs by 100%.

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How to remove myoma during pregnancy planning?

The question of the method of surgery in the case of uterine fibroids is rather complicated. Laparoscopy, on the one hand, has more advantages, the main of which is reducing the likelihood of adhesions in the small pelvis. Subsequently, this will allow preserving patency in the fallopian tubes, which is an important factor when fertilizing an egg. During laparotomy, the probability of formation of adhesions is significantly higher, and their appearance becomes possible in the pelvis and in the abdominal cavity. In the future, this will lead, in addition to infertility, to complications in the gastrointestinal tract.

However, on the other hand, it is believed that in the case of large sizes of fibroids, during laparoscopy, it is not always possible to close the uterus as necessary. It is associated with laparoscopic technique.

The quality of healing of the suture on the uterus can vary in different patients and depends on several factors:

  1. Body features
  2. The quality of the scar during the closure of the uterus (scar formation, correctness of the comparison, the stitching of layers)

So, the most optimal (maximum) knot size for a possible laparoscopy for a patient planning to become pregnant is 5-6 cm. In this case, special skill of the surgeon is necessary for sewing. In the case of large nodes, new technologies have already been developed for uterus suturing, which make it possible to strengthen its walls, but the risk of uterine rupture along the scar is always higher.

In the presence of nodes larger than 9-10 cm, the risk of rupture along the scar is higher than the risk of the formation of adhesions after laparotomy. Here surgeons, as a rule, refuse from laparoscopy and perform a celiac section, taking into account the reproductive wishes of the woman.

The frequency of the formation of adhesions after laparoscopy is significantly lower than with ovarian section (laparotomy). But with large myoma nodes, endometriosis and inflammation of the appendages, genetic features in the postoperative period there is a risk of re-development of adhesions. According to statistics, the probability of formation of adhesions is higher when the myoma node is localized in the uterus on the back wall. The reasons for this fact are not clear at the moment.

If there are concomitant pathologies (chlamydia, endometriosis, gonorrhea, etc.) in patients who are interested in pregnancy, after about 6-8 months, control laparoscopy is performed to assess the condition of the fallopian tubes. The question of re-operation is always solved individually, taking into account many factors and individual characteristics.

After a laparotomy on the occasion of the removal of large fibroids, due to the fact that the likelihood of adhesions is high, control laparoscopy is performed in most cases in order to restore the patency of the fallopian tubes.

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When can I get pregnant after surgery?

After surgery to remove fibroids, regardless of the method (laparotomy or laparoscopy), you can become pregnant after 8-12 months, it depends in most cases on the size of the remote site. With small sizes (3-4 cm), pregnancy can be planned in eight months. Such restrictions are associated with the physiological characteristics of the recovery of the muscles of the uterus. Resorption of sutures on average completely ends only after 90 days from the day of surgery. Given that the size of the uterus during pregnancy increases significantly, the muscles stretch and hypertrophic very strongly, it is necessary that the healing of the scar was complete.

Indications for cesarean section after a similar operation are determined individually each time and depend on the size of the fibroids, which was removed, because this affects the size of the scar, from its previous location, from concomitant indications (the age of the pregnant woman, the duration of infertility treatment, the presence of preeclampsia), from the ultrasound data of the suture during pregnancy.

In general, when removing fibroids up to 3-4 cm, in the absence of complications, young age, satisfactory state of the scar according to the ultrasound, it is possible to conduct a natural birth.

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Uterine rupture and multiple myoma

After the operation to remove fibroids, after the previous cesarean section, in any case, if there is a scar on the uterus, there is a possibility of its rupture during pregnancy. According to some data, the frequency of breaks is about 6%, but this is not an exact figure.

The probability of rupture is difficult to determine, because it is determined by the individual characteristics of the tissues of the muscles of the uterus, it is almost impossible to evaluate them. Patients with a scar on the uterus need a more careful attitude in the management of pregnancy, it is necessary to constantly evaluate the blood flow in the rumen, its condition, a timely planned delivery plan, early hospitalization before delivery, etc. are necessary.

In most cases, fibroids are represented by several nodes. The situation with the planning of pregnancy in multiple myoma is quite complicated. In some cases, several nodes of different sizes are localized in the uterus, and if all of them are removed, healthy tissue can hardly remain.

In these cases, only those myoma nodes that interfere with pregnancy are removed, i.e. localized so that the embryo is prevented from attaching, or those nodes that have a tendency to grow rapidly. After delivery, you can already remove the remaining nodes or carry out the removal at caesarean section. To remove all myomatous nodes when planning and preparing for pregnancy in the case of a large number of them is impractical, because this can adversely affect the very possibility of getting pregnant, carrying and during childbirth.

Knyazeva Tatyana Viktorovna

Psychologist, Practicing Clinical Psychologist. Specialist from the website b17.ru

And I gave birth to my two.

And with a rather large myoma, I endured two without problems and gave birth. To me, the doctor categorically forbade her to be removed before delivery. My subserous on the back wall was 45 mm in size. At conception did not affect, during pregnancy only increased to 6 cm and that's it. When such fibroids are removed, a scar remains on the uterus and a uterine rupture may occur during pregnancy. And here it is kapets
So consult a few doctors about what specific fibroids are and how appropriate it is to remove them for future pregnancies and deliveries.

I probably upset you .. I went to remove myoma, and I was removed in FIG all and the uterus and one ovary, you know, and simply thanked God and that she had at least one to give birth. The news about the removal of everything cleaned up was brought to me exactly in the hospital, and I laid down on a planned operation and then brought a piece of paper, like you agree and so that everyone cut you on the female line .. I sobbed a full day, it was not an ordinary hospital and the Central Clinical Hospital

3, and maybe in vain? My daughter-in-law also offered, let's cut out everything, she refused, the current myoma, six months later she got pregnant.
with the birth of one child gave birth, but everything was linked with the threat ..

Anna, and what size and what fibroid was before pregnancy?
I have here two fibroids - 6 cm and 3 cm on the front and back wall, intermuscular. Some doctors say to remove, others don’t touch before giving birth. I try to get pregnant for half a year. I am 36.

Girls, I had as many as 8 knots, though small. I tried to get pregnant for 1 year, it did not work. And so it happened, in July of this year I became pregnant, the result was a miscarriage (((And then I decided to remove, the doctor I said that after 6 months I can already plan, and that with my multiple fibroids, I couldn’t get pregnant, but I could not bear it either.

Related topics

Anna, and what size and what fibroid was before pregnancy?
I have here two fibroids - 6 cm and 3 cm on the front and back wall, intermuscular. Some doctors say to remove, others don’t touch before giving birth. I try to get pregnant for half a year. I am 36.

Anna, thank you, give hope! Glad you won it))
And get pregnant on any cycle happened, if not a secret?

Girls, hello! Tell me please, did anyone manage to get pregnant after removing fibroids?

Removed myoma from Dr. Puchkov. After the operation, she gave birth to a miracle daughter.
Good luck to you and the baby

Guest Removed myoma from Dr. Puchkov. After the operation, she gave birth to a miracle daughter.
Good luck to you and the baby. And how many months did you get pregnant and how was your fibroid?

There were 2 operations. Одна -4 фибромы от 4 до 9 сантиметров. Второй раз была одна 5 см. Забеременела через 8 месяцев.

Были 2 операции. Одна -4 фибромы от 4 до 9 сантиметров. Второй раз была одна 5 см. Забеременела через 8 месяцев.

Растила свою миому с 5мм. до 6см. (надеялась на чудо-рассасыванье), не могла забеременеть 8 лет, итог, когда наступила долгожданная беременность на 7 неделе плод замер - плацентарная недостаточность, через 2 недели иду на операцию, потом надеемся на лучшее. Врач говорит,что можно планировать через 8-12 месяцев. Everyone has their own history and their sores, but do not believe in a miracle, believe the doctors. Good luck everyone.

Removed myoma from Dr. Puchkov. After the operation, she gave birth to a miracle daughter.
Good luck to you and the baby

Irina, I heard from many doctors that usually six months after the operation, you have to wait with conception. Months 8 certainly will be enough) They watch the suture as it heals and in fact speak exactly when you can stop protecting yourself.

Lion girls Dr. Martin Taras Yulianovich

I had a fairly large myoma removed using a hysteroresectoscopy. After removal, an inner scar is left on the uterus. She became pregnant quite easily and if she didn’t relax (went on foot a lot) and saved herself, the pregnancy would have passed much easier. And so on the 30th week a pissary was installed, which, when washed, provoked the detachment of the planants. The last 2 months had to spend on strict bed rest. Then the cop.

I am 35, no children, 5 years hope for a miracle, but I see you have to do an operation. Myoma subser-intramur 6cm, in this cycle we will do the second AI. So I am afraid of the operation, suddenly the doctors will leave me without a womb. What to do ??

I am 35, no children, 5 years hope for a miracle, but I see you have to do an operation. Myoma subser-intramur 6cm, in this cycle we will do the second AI. So I am afraid of the operation, suddenly the doctors will leave me without a womb. What to do ??

DO NOT sign an agreement on the removal of the uterus, only on the removal of fibroids, I have a large myoma of 7 cm intramural removed 7 months have now passed, I feel fine

I have two intramural fibroids, one 5 cm and a second 4 cm along the back and in front of it. Doctors speak delete. I still wait until November, if I don’t get pregnant, then I’ll go delete, but I’m afraid everyone will chop it off .. Or later I will not get pregnant (

I tried to get pregnant for 7 years with submicose-interstitial myoma (10 weeks). There were two pregnancies, both times there was a miscarriage. Three weeks ago, had surgery to remove fibroids. Everything went well. The doctor said that you can plan a pregnancy in 6-8 months. But first you will need to consult your doctor.

I have fibroids 6.7 weeks, pregnancy 5-6 weeks, can I carry a child with myoma

My sister gave birth to a wonderful girl at the age of 45 after removing fibroids.

Tell us, pzhl, as after the removal of monthly came. I was assigned Janine for two months without a break, then a break of 7 days and again two months without a break. The first months came 10 days after the operation, painlessly and poorly. But now it's already the ninth day, how the lower abdomen hurts decently. I do not know whether it is normal or to run to the doctor? Janine drink 8 days.

Girls, and how you used to remove the laparo or open cavity, and then I have on the back of the intramuscular 6 cm. And the doctor says that you may have to remove ate laparo with the uterus.

Girls, and how you used to remove the laparo or open cavity, and then I have on the back of the intramuscular 6 cm. And the doctor says that you may have to remove ate laparo with the uterus.

I did the lane, 3 months ago myoma was 7 cm along the back wall.

I did the lane, 3 months ago myoma was 7 cm along the back wall.

I have fibroids 6.7 weeks, pregnancy 5-6 weeks, can I carry a child with myoma

Girls, I also got pregnant with two subserous fibroids (3 and 7 cm). Myomas were removed during cesarean. two years have passed. Now the ultrasound is spoken by a very thin wall of the uterus in this place; a rupture is possible during the next pregnancy Tell me, and who had the experience of pregnancy, after abdominal removal of fibroids? Scary, how dangerous is it?

Go to Puchkov, save the uterus ... I removed a huge myoma with a lapar of 13 cm

Girls, and how you used to remove the laparo or open cavity, and then I have on the back of the intramuscular 6 cm. And the doctor says that you may have to remove ate laparo with the uterus.

DO NOT sign an agreement on the removal of the uterus, only on the removal of fibroids, I have a large myoma of 7 cm intramural removed 7 months have now passed, I feel fine

the girls removed me with a laparotomy 3 the size of the uterus in its muscular wall in the front and numerous inside and outside the uterus were kept in Donetsk by a professor gull. said before the operation: or remove the incision in the entire abdomen or uterus. so the incision is HUGE, but now the uterus on the spot is now waiting for you to be allowed to save. The operation was 03/10/2013. Yes, the uterus was increased by 15 weeks.
Good luck and good doctors.

I have a uterine myoma removed on 20. 03.2013. There were numerous nodes, the largest 8 cm, another large external and many small ones. Before the operation, all attempts to get pregnant failed. The operation was done in a paid hospital, so they immediately asked me whether to keep the uterus or not. I said I want to save. So did. Doctors recommended pregnancy after 3, and preferably 6 months after surgery. She got pregnant after 9 months after surgery.

Light, how good that you could get pregnant! it gives hope.
Girls, after my lapar the first menstrual periods are very painful. I climb on the wall of pain. Has anyone had this? I usually have tolerated monthly periods before. Maybe this is due to the fact that not everything has healed inside after the operation and it will be better further.
Another question - I was not prescribed any treatment after surgery. No hormonal drugs and contraceptives. What should I take advise.

Light, how good that you could get pregnant! it gives hope.
Girls, after my lapar the first menstrual periods are very painful. I climb on the wall of pain. Has anyone had this? I usually have tolerated monthly periods before. Maybe this is due to the fact that not everything has healed inside after the operation and it will be better further.
Another question - I was not prescribed any treatment after surgery. No hormonal drugs and contraceptives. What should I take advise.

ME REMOVED THE 18TH WEEK

I had myomectomy in October 2013, I really want to start planning, I drink the 4th month Janine, I read a lot about pregnancy after the removal of fibroids, I also wrote on the websites of specialists, I learned from numerous information that everything is individual, but I need to plan not earlier than in 6 months, although the scar is formed in 3-4 months and remains unchanged. I really want to start planning in March, but it's scary.

I have my fibroids removed for 20 weeks. subserous on the front wall, not on the leg. There was also a deformation of the uterus. Of course, they offered to remove everything, but I did not want to remove the uterus. As a result, abdominal surgery removed only myoma. Thanks to the doctors. Now I want to plan a pregnancy. Already a month has passed after the operation. I am 42 years old.

Girls, hello! Tell me please, did anyone manage to get pregnant after removing fibroids?

I was removed myoma through the abdominal route, got pregnant after a month, I do not know what to do, tell me.

The girls are already at home here, they were operated on 5 days ago. I’m 22 and single and no child, myoma was 6 cm. The first 2 days after the operation, she died of pain. A female doctor didn’t delete me, and he didn’t offer me, although the fibroid was in the womb, I was even surprised why I’m afraid. Now I hope for the best and wish you all good luck!

A year ago, myoma (s) was very large (1.5 kg) - they operated on - abdominal surgery, they left the womb, they wanted a baby. Almost all eco were after that - absolutely unsuccessful.
Yak - is, embryos - is, good, and there were five days, only they would plant. and in response, silence.
Doctors began to spread rot to me with age, but I didn’t believe that my grandmother gave birth to a son at 46 years old — naturally, she became pregnant.
And today - for the first time. There is hCG. HOORAY. I still do not believe in this miracle.

on day 20 DPO HCG - 1212

Myoma was removed by a band operation, 9 cm. I cannot take contraceptives for some reason, my husband never used condoms, we protect ourselves as much as we can! I'm afraid to get pregnant before the time, tell me who knows what the minimum time must pass after the operation, so that you can get pregnant.

I was removed myoma through the abdominal route, got pregnant after a month, I do not know what to do, tell me.

Hello, a month ago I was diagnosed with multiple uterine fibroids, 3 nodes, dominant 2.5 cm subserous, 2 nodes in the isthmus 16 and 8 mm (1 on the back wall), I am 23 years old. The doctors said that it is necessary to get pregnant urgently, or after half a year with the growth of the operation nodes, and after it there is a big risk of normal delivery. for my own reasons I cannot get pregnant the next year, I am also afraid of operations and the very fact that I can be left without babies is frightening (((

I was removed myoma through the abdominal route, got pregnant after a month, I do not know what to do, tell me.

And I would like to add - the girls, upon learning that you have fibroids - DO NOT PULL. Nothing good from the fact that you will shed tears at night in the pillow and delay the treatment will not work! Myoma will grow and the chances that everything will end well will decrease with each passing month. Be sure to consult with SEVERAL DOCTORS. And listen carefully to what they say. The probability of a surgical issue is great, so prepare yourself for finding a good surgeon. In principle, with the question of myoma - this is your main task - to find a good surgeon. Good luck to you girls.

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