How long to get pregnant after removing fibroids. Pregnancy after surgery to remove uterine fibroids

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

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The effect of surgery 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 the removal of fibroids, the reproductive function is impaired. But depending on the type of surgery, the problem may be temporary or permanent.

When using sparing methods of treatment, only the tumor itself, or part of the tissues of the organ, together with the myomatous node, is removed. In this case, the reproductive organs continue to function normally after restoration. Only when the organ itself (the uterus) is removed, the diagnosis of "infertility" is made. In other cases, the possibility of conception, according to statistics, remains in 85% of women. The remaining 15% include patients with complications.

Hysteroscopy

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

Hysteroscopy

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

Hysteroscopy is used to diagnose very small neoplasms located on the surface of tissues inside the organ cavity. Hysteroscopy is not recommended for all patients, as it has multiple contraindications.

Laparoscopy

In most cases, treatment in the presence of myoma nodes is carried out by laparoscopy. The method is considered quite modern. To perform the operation, the surgeon needs to make three incisions through which the tumor is removed. Used to eliminate formations of small sizes.

Laparoscopic removal of fibroids

Pregnancy after laparoscopy of uterine fibroids is possible. But it takes much more time to restore reproductive functions after laparoscopy than when using hysteroscopy.

Recovery takes at least six months. In case of complications, the patient needs to undergo additional treatment. Before planning a conception, the consent of the attending physician should be obtained.

Myomectomy

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

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

Cavitary

The appointment of abdominal surgery occurs in the presence of complications. The abdominal method involves making an incision on the uterus or its complete removal. If the organ is preserved, a woman has a high chance of becoming pregnant.

Abdominal surgery to remove fibroids

The cavity method is the most traumatic, for this reason it is recommended to plan a pregnancy no earlier than a 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.

Removal of uterine fibroids, regardless of the method used, is a serious operation that has a direct impact on the condition of the reproductive organs. Under the influence of the disease and subsequent treatment, the entire reproductive system is disrupted. Pregnancy after successful treatment is desirable to plan, having previously passed all the necessary examinations to exclude the pathological course of fetal development and the period of its gestation.

Despite the fact that with a positive outcome of the operation, conception can occur even after two to three months, experts recommend using contraceptives for at least six months. In order for the body to fully recover, it will take at least a year.

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 after 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. Injury to tissues, suturing and direct damage to the organ leads to the presence of painful sensations for a long time. The uterus itself also takes a long time to recover. It takes about ten days for the incision to heal, but full recovery takes 1 month.

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 rehabilitation, the menstrual cycle is also restored, which is very important for conception.

Restoration of the menstrual cycle

Uterine fibroids are often triggered by hormonal disorders. The imbalance of hormones also affects the functionality of the ovaries, which are responsible for the menstrual cycle. In the first month after the operation, menstruation may not come on time. After hysteroscopy and laparoscopy, the cycle should be restored already in the second month. With abdominal surgery, menstruation may not be regular for three to six months.

In some patients, menstruation may be completely absent in the first four to six weeks. If this interval is prolonged, then you should contact your doctor to identify the causes of the deviation. There may be a violation of the functionality of the ovaries.

As soon as menstruation becomes regular and all the necessary examinations are carried out, a woman can plan a pregnancy, but only with the prior consent of the doctor.

Pregnancy planning

To increase the chances of successful conception, the normal course of pregnancy and the delivery process, it is necessary to properly prepare the body for the upcoming changes.

Preparation for pregnancy planning includes an examination:

Ultrasound of the uterus and ovaries;
kolkospopia;
delivery of analyses.

You should also take medications for prevention:

folic acid;
hormones;
vitamins.

exclusion of the use of alcohol and tobacco products;
food mainly with natural products;
exclusion of any stressful situations;
limitation of physical activity.

In the absence of contraindications to conception, you should also monitor the periods of ovulation, in which the chances of becoming pregnant are much higher.

Uterine fibroids should not be perceived by a woman as a sentence. The tumor is benign in nature, so the disease can be completely cured. The most important thing is to start treatment on time to avoid complications.

With timely diagnosis of neoplasms and complex treatment, after removal of fibroids, a woman may not worry about the opportunity to become a mother. When a tumor is detected in patients of childbearing age, doctors seek not only to get rid of the disease, but also to preserve the reproductive organs with the possibility of their full functioning. To prevent radical methods of treatment, experts advise the fair sex to regularly visit a gynecologist, at least twice a year.

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

When to plan pregnancy after UAE?

It should be noted right away that uterine embolization in no way affects the reproductive functions of the female body. This is a procedure that hundreds of women go through every year, and most of them give birth to full-term and completely healthy babies after some time. Myoma can be removed in many ways, however, cases when there were difficulties with the subsequent fertilization of the egg in medical practice are very rare.

When can you get pregnant after removing fibroids? It is difficult to give an unequivocal answer, because each patient has her own individual characteristics of the body, which cannot be ignored in this situation. Since bearing a fetus is a very serious matter, it must be approached with responsibility, not neglecting even the most insignificant, at first glance, nuances.

Gynecologists believe that ... ... after the treatment of the disease, no matter how it is carried out, at least 9 months must pass before a 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, indeed, for the entire female body.

But sometimes it may take more time to completely regenerate the tissues of the walls of the uterus. This occurs if the fibroid was multiple and affected a significant part of the cavity of the reproductive organ. Doctors may recommend delaying pregnancy planning for 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 course of treatment is over, you need to see a doctor and undergo an examination.

Under what conditions are fibroids and pregnancy compatible concepts?

The presence of a benign neoplasm in the uterine cavity is not a sentence, and full bearing of the fetus is possible if:

The tumor is not located directly on the walls of the reproductive organ.
Myoma is not of critical size, which will not put pressure on the placenta.
The uterus has no other pathologies.

Of course, any nodes, even benign ones, can seriously affect pregnancy, which is why it is necessary to remove them before a woman decides to become pregnant.

What are the complications of the operation?

Pregnancy after undergoing tumor removal is impossible in 2 cases:

The nodes located in the uterine cavity prevent the fetal egg from attaching to its walls.
The neoplasm blocks the path of spermatozoa into the fallopian tubes, as a result of which the seminal fluid cannot reach the egg, and its fertilization does not occur.

Many patients are worried about how, and is it possible to get pregnant at all after removal of uterine fibroids? Doctors on this score are unanimous: if all favorable conditions are created for fertilization, then you can get pregnant both naturally and with the help of IVF.

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

Endometriosis.
Polycystic ovaries.
endometrial polyps.

If pregnancy has already begun, and only then the expectant mother found out about the presence of the disease, then first you need to register with a gynecologist. Only he will be able to decide on the elimination of fibroids, if necessary.

Possible complications after UAE can be:

spontaneous abortion (miscarriage);
premature birth;
fetal hypotrophy;
cord injury;
discovery of postpartum hemorrhage;
damage to the placenta;
difficult childbirth.

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

Although the removal of a neoplasm using UAE 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 poor thrombosis, then any surgical intervention can lead to the fact that you will not be able to get pregnant, and in some cases even death is possible.

Childbirth after surgery: caesarean or vaginal delivery?

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

Indeed, this is a very important decision for any woman who has undergone hysterectomy. As a rule, after this manipulation, the patient's body recovers quite 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 before planning it, you can take special vitamins for several months.

If there are no complications after the operation, then you can safely decide on natural childbirth - they will not harm either you or the baby. Caesarean section is used only in extreme cases, when multiple nodes were found in the uterine cavity. They can put pressure on the fetus and placenta, which can subsequently lead to disruption of its normal and full functioning.

After removal of the tumor in a caesarean section, there is almost never a need, so women are able to endure and give birth to a baby on their own. Natural childbirth has a positive effect on the full recovery of the body after surgery, and in some cases even prevents the recurrence of uterine fibroids.

Planning pregnancy with multiple myoma

When can I get pregnant after uterine fibroid surgery? The answer to this question can only be given by a doctor. But in any case, it is necessary to plan pregnancy after surgery to remove uterine fibroids, taking into account the severity of the disease, as well as the condition of the future mother after UAE. To do this, you need to undergo a complete medical examination.

However, there are cases when the consequences of a neglected disease are truly catastrophic and during the operation not only multiple fibroids are removed, but also the uterus itself. This happens if you do not pay attention to alarming symptoms in time, and do not start therapy.

In this case, a woman will never be able to get pregnant. Therefore, it is better not to delay a visit to the gynecologist when at least some suspicions arise. After removal of all neoplasms, a long period of time must pass, during which the wounds in the uterine cavity will completely heal, and the vessels will restore normal blood circulation in the reproductive organ.

Before you decide to get pregnant, you need to make sure that your body is fully prepared for this. To do this, it is necessary to take into account important factors that can affect both the course of pregnancy and the subsequent process of childbirth:

size of postoperative scars;
age of the future mother;
if the patient has already given birth, then the course of the previous pregnancy must also be taken into account.

These points do not mean at all ... ... that a woman is at risk, but in order to avoid unpleasant consequences, you need to remember them.

It is important for women not to forget that it is possible to become pregnant after removal of the uterus, only during this period all the recommendations of the gynecologist must be followed. Uterine fibroids are treated both with the help of sparing methods (pills, vitamins and other medications), and through surgical intervention. Yes, and pregnancy after removal of uterine fibroids does not threaten with serious complications, especially if the expectant mother takes care of her health in advance and creates favorable conditions for the full intrauterine development of her unborn child!

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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, myomatous tumors. How does pregnancy proceed after removal of fibroids, and why complications may arise?

What types of surgery are used?

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

Hysteroscopy is one of the safest ways to remove uterine fibroids for a woman who wishes to have a child in the future. The doctor does not make any incisions, penetration into the uterus is carried out through the vagina.

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

Laparoscopy is also safe for expectant mothers, as it allows you to preserve the childbearing function in full. A woman after therapy is rehabilitated in a short time, after about six months she has the opportunity to plan the birth of a child.

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

In some cases, patients have to agree to abdominal surgery to remove uterine fibroids. This can only be done in particularly severe cases. After such an operative intervention, the reproductive organ acquires scars, the menstrual cycle fails.

The patient needs quite a long time to fully rehabilitate. Pregnancy after this type of myomectomy is possible no earlier than a year later. The probability of conception is very high, but the bearing of a child can be complicated, since there are scars on the uterus.

Is it possible to get pregnant after therapy?

Is it possible to get pregnant after fibroid removal? Thanks to modern medical techniques, it has become possible to preserve the childbearing function in women. The main thing is that in the future after the operation there should be no complications that would prevent the conception and bearing of the baby.

After surgery, the following risks are possible:

The formation of adhesions that can prevent a woman from carrying a child normally.
Re-development of uterine fibroids. No operation can guarantee that after some time the pathology will not reappear. This doesn't happen very often, but it's still possible. This can make it difficult to conceive and carry a baby.
The appearance of scars on the walls of the uterus and bleeding. Scars can form during abdominal surgery. This as a result leads to the development of ectopic pregnancy after removal of fibroids, spontaneous abortion.

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

The prognosis regarding the favorable bearing of a child is based on how many such injuries are on the uterus, whether the reproductive organ itself was opened, whether a scar can grow before the baby is born. All these factors determine whether a woman bears a child after surgery 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 is created to the normal attachment of the placenta. The fetal egg cannot find the most favorable place for itself, so it has to attach itself in a not very convenient place.

If the fetal egg stops its choice of location on the lower region of the genital organ, then the woman has a complete placenta previa, and the likelihood that bleeding will be disturbed during the bearing of the baby increases. With such a diagnosis, a pregnant woman will not be able to give birth on her own, so a caesarean section is prescribed.

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

When the fetus does not fully provide oxygen, disturbances in the intrauterine development of the child's brain occur. 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 malfunctions in the work of the child's body are guaranteed.

The occurrence of a uterine rupture

Another rather dangerous condition for a woman, when pregnancy occurs after removal of uterine fibroids, is a rupture of the organ at the place where the scar passes. This can happen both during gestation and during labor.

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

Nausea and vomiting.
Pain in the abdomen, radiating to other areas of the body.
Overstrain of the muscles of the reproductive organ.
Blood discharge from the vagina.

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

The rapid deterioration of the general condition of a woman.
Vertigo.
Reduced blood pressure.
Increased heartbeat.
Broken breath.
Paleness of the skin.

When the uterus ruptures, a lot of blood enters the abdominal cavity, fetal hypoxia occurs, and the baby's condition worsens. In this case, urgent medical attention is important.

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

Nausea, vomiting.
Pain syndrome.
Weakness.
Increased pain during contractions.
Poor progress of the baby, despite the full disclosure of the uterine cervix.

Also, an overstrain of the muscles of the uterus is added, 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 provide urgent medical care, otherwise the pregnant woman and the baby may die.

How is a second pregnancy planned and managed?

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

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

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

If an inconsistent uterine scar is detected, then the woman will not be allowed to give birth on her own. In this case, only a caesarean section is indicated. Otherwise, natural childbirth after myomectomy can cause a rupture of this damage, the formation of bleeding, the death of the woman giving birth and the child himself.

If a full-fledged scar is found, the doctor may allow you to give birth on your 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 woman.
Finding the placenta outside the scar.
The absence of negative consequences of bearing a child.

In the case when the myomectomy of the uterus is carried out directly during the bearing of the baby, then the woman will give birth exclusively by caesarean section. If in the process of natural childbirth with a full-fledged scar, complications suddenly arise or the condition of the baby worsens, then emergency assistance is provided through a caesarean section.

rehabilitation period

In order for a woman to be able to fully recover and think about future offspring, she needs to follow certain rules after laparoscopy of uterine fibroids or other operations. The patient must take the medicines prescribed by the doctor.

At home, it is important to monitor your health, you should not allow overwork, hypothermia, lifting heavy loads, prolonged stay in the sauna, bath or on the beach. You need to spend more time outdoors, eat right.

Thus, it is possible to conceive and give birth to a child after a removed fibroid, even of a large size. But it depends on many factors, so each case is individual. When you can conceive a child, only the attending physician can say more precisely.

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uterine fibroids during pregnancy

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

Fibroids are benign tumors made up of muscle tissue.

Occurs when the muscle cells of the uterus actively begin to divide. Doctors have not fully figured out why this happens, but the most likely cause is hormonal stimulation and increased secretion of estrogens. Back to content

Is it possible to get pregnant with uterine fibroids?

The answer to this question depends on many factors to consider:

Localization of the myomatous node

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

With small sizes of myomatous nodes and location in the wall of the uterus itself or outside (subserous localization), in the absence of deformation of the cavity, pregnancy can occur under other satisfactory conditions. In the case of the nodes described, it is possible to plan a pregnancy. In the future, problems are still possible, they can be associated with gestation, but according to statistics, their frequency is about 15-20%.

If there is a node with a thin stem, during pregnancy there is a risk of torsion, this will lead to emergency surgery and possible interruption. If you are preparing to become a mother, such nodes should be removed first.

If, according to the results of ultrasound and observations, the fibroid is growing rapidly, i.e. increases in size by 1.5-2 times in a period of six months, then planning a pregnancy with uterine myoma is impossible. In this case, there is a high risk of growth of fibroids during gestation, there is a possibility of a violation in the nutrition of the myomatous node, and the risk of miscarriage increases. In this case, it is necessary to pre-treat.

If the fibroid is large (the size of the uterus exceeds 10-12 weeks of pregnancy, and in the case of IVF if the fibroid is more than 4 cm), it is not worth planning a pregnancy, there is a high probability of miscarriage and malnutrition during the gestation period, which can lead to emergency surgical intervention . Yes, and the onset of pregnancy in this case is unlikely, because. in 60-70% of such patients, endometrial pathology occurs, which makes it impossible to implant the embryo.

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

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How to remove fibroids during pregnancy planning?

The question of the method of surgical intervention in the case of uterine fibroids is rather complicated. Laparoscopy, on the one hand, has more advantages, the main of which is a decrease in the likelihood of an adhesive process developing in the small pelvis. Subsequently, this will maintain patency in the fallopian tubes, which is an important factor in the fertilization of the egg. With laparotomy, the likelihood of adhesion formation is noticeably higher, and their appearance becomes possible both in the small 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 fibroids, when performing laparoscopy, it is not always possible to suture the uterus in the right way. This is associated with laparoscopic technique.

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

Body features
The quality of the scar when suturing the uterus (formation of the scar, correct matching, layering of suturing)

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

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

The incidence of adhesion formation after laparoscopy is significantly lower than during laparotomy. But with large myomatous nodes, endometriosis and inflammation of the appendages, genetic features in the postoperative period, there is a risk of re-development of the adhesive process. According to statistics, the likelihood of adhesion formation is higher when the myomatous 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, a control laparoscopy is performed to assess the condition of the fallopian tubes. The issue of reoperation is always decided individually, taking into account many factors and individual characteristics.

After a laparotomy in case of removal of a large fibroid, due to the fact that there is a high probability of formation of adhesions, 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 removed node. With small sizes (3-4 cm), pregnancy can be planned in eight months. Such restrictions are associated with the physiological characteristics of the restoration of the muscles of the uterus. The resorption of sutures, on average, is completely completed only after 90 days from the day of the operation. Given that the size of the uterus during pregnancy increases significantly, the muscles stretch and hypertrophy very much, it is necessary that the healing of the scar is complete.

Indications for caesarean section after such an operation are determined individually each time and depend on the size of the fibroids that were 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 ultrasound data of the suture during pregnancy.

In general, with the removal of fibroids up to 3-4 cm, the absence of complications, a young age, and a satisfactory condition of the scar according to ultrasound, natural childbirth is possible.

Myoma is a benign tumor formed from connective tissue. May be on the walls or in the uterine cavity. A fairly common disease. It is diagnosed in most cases by the age of 35 in 45% of women. At risk are patients from 35 to 50 years. The size of the tumor is different. In some cases, a small knot is fixed, in others a ball weighing up to 1 kg. In the latter case, it is easy to feel it by palpation of the lower abdomen. Pathology does not appear immediately, but the later it is detected, the more difficult it is to treat. Along with the severity of therapy, the risk of complications increases, among which is infertility. Most often, the cause of the growth of connective tissue is an increased amount of the female hormone - estrogen. Despite the fact that the tumor is benign, it brings significant difficulties to the woman, among which are uterine bleeding, as well as problems with conception. Women very often wonder if pregnancy is possible after removal of uterine fibroids? To answer this question, one should understand the causes of the appearance of a tumor on the reproductive organ, as well as study the methods of surgical intervention.

Causes of fibroids

The basis of the pathological changes in the cells of the organ is an imbalance in the hormonal background, including estrogen and progesterone. Violation of the norm leads to cell mutation, and as a result, its growth. Among the causes of the tumor are the following factors:

Fibroids can appear even during pregnancy. Such cases are diagnosed if a woman becomes pregnant late for the first time. Having determined the cause of the disease, it is required to eliminate it in order to exclude problems with conception.

The impact of surgery on reproductive function

Removal of fibroids is carried out by a conservative method. After the operation, of course, the childbearing function is disturbed. Depending on the type of surgery, problems with conception are both temporary and permanent. Therefore, pregnancy after removal of fibroids is possible, but taking into account the method of the operation. A sparing method of treatment is distinguished, which minimally injures the tissues of the uterus. After the restoration of the shell of the organ, with the permission of the doctor, conception is possible. In some cases, the tumor has a significant size, or an unfortunate location, that doctors resort to the decision to remove the entire organ. In this case, infertility is already diagnosed. According to statistics, the removal of fibroids does not affect fertility in 85% of women. In the remaining 15%, it is not possible to save the functionality of the uterus (most often this number includes patients with severe complications of the genital organs).

Tumor Removal Methods

There are several removal methods:

Pregnancy after removal of subserous fibroids is also possible if the organ remains intact. For conception, it is required to undergo a course of treatment and restore the functionality of the uterus. Only after the approval of the doctor and passing the tests is it allowed to become pregnant. By itself, fibroids are not the cause of infertility, it only prevents the fetal egg from attaching, therefore, after removal and restoration, the reproductive function of the female genital organs is quite functional. The main aspects in achieving a positive result are following the doctor's recommendations, pregnancy planning and careful preparation of both parents for conception.

Pregnancy after removal of fibroids should be planned and only after a certain period of time, which will be affected by the type of operation - classical laparotomy, laparoscopy or hysteroscopy, and the speed of recovery. On average, the time for which conception should be postponed is from six months to a year. It is during this period that the tissues will heal well, the scar will become dense, which will reduce the risk of possible complications during gestation.

In some cases, women become pregnant along with education, but this can lead to accelerated node growth, uterine deformity, placental abruption, malnutrition of the baby, and so on.

Opinions about whether or not to have surgery on the eve of pregnancy differ. As practice shows, women successfully bear babies even with a large number of such tumors. However, such a pregnancy often lies in wait for multiple "pitfalls".

It is unequivocally considered that the following nodes must be removed:

With rapid growth lately.
More than six centimeters in diameter - in this case, they can deform the uterine cavity and prevent the fetus from developing normally. The baby may have various anomalies of the skeleton and soft tissues - depressions of the skull and chest, pathology of the development of the limbs, etc.
Multiple nodes more than three centimeters in diameter.
With submucosal growth - if they increase towards the uterine cavity. Such nodes lead to placental abruption, malnutrition of the baby through the vessels of the umbilical cord and other abnormalities.

Types of fibroids depending on the localization of myomatous nodes

Fibroids can be removed in several ways - through a classic laparotomy operation, by laparoscopy or hysteroscopy.

Laparotomic operation

It is considered the method of choice for those women who are planning a pregnancy. This is a classic version of the surgical removal of nodes. The disadvantages of the method are as follows:

A noticeable seam remains on the anterior abdominal wall - longitudinal or transverse.
The operation is accompanied by significant blood loss, pain syndrome.
The rehabilitation period is long - at least a month or two.

The main advantage of laparotomic surgery and removal of myoma nodes in this way lies in the quality of the sutures on the myometrium. Only "with his own hands" the surgeon can so carefully compare the tissues and take in everything in layers. Subsequently, this is a guarantee that a woman will be able to carry a baby without complications. The probability of uterine body rupture along the scar in such cases is no more than 5-7%.

Particular preference should be given to such operations in cases where the myomatous nodes have interstitial growth and there is a possibility that the uterine cavity will be opened during the operation. It is impossible to apply such sutures that will later lead to a full-fledged scar using laparoscopic technique.

Laparoscopy as an option for removal of uterine fibroids before pregnancy

Laparoscopy should be preferred if the woman is not planning pregnancy after removal of the fibroids. In a non-pregnant state, the uterus after surgery will never give any complications. Another thing is if a woman is still planning to give birth. In this case, only not very large (preferably up to 3 cm) nodes with subserous growth can be removed laparoscopically - they “like mushrooms” sit on the uterus.

And even in this case, classical laparotomy should be preferred.

Several five years ago, after the introduction of laparoscopy and understanding of its advantages over conventional operations, all women who planned pregnancy underwent removal of myoma nodes with this latest equipment.

However, after this, it was found that the course of pregnancy in women with previous laparoscopy for the removal of nodes is complicated by uterine ruptures in the third trimester, often with fetal death and a real threat to the woman's life.

Laparoscopic surgery

After a thorough analysis of the situation, it was concluded that laparoscopic myomectomy is not a method for those who are planning a pregnancy. The fact is that it is extremely rare to impose full-fledged seams. As a rule, the myometrium heals, but during pregnancy, as the uterus grows, the tissues cannot withstand the tension due to their failure and are torn. Moreover, this happens instantly and often in the first minutes is hardly noticeable, and everything can end very tragically.

Other options

You can prepare for pregnancy using other advances in medicine to remove myomatous nodes.

For submucosal localization, hysteroscopy should be preferred - this is the most minimally invasive and sparing operation in this case.

EMA

In some situations, uterine artery embolization (UAE) is suitable, after which the nodes decrease in size and do not cause concern during pregnancy. Studies of pregnant women after UAE for fibroids prove that the fetus develops normally and does not experience a deficiency in the blood supply. The functions of the placenta are also not violated.

Watch this video about the cases in which the patient undergoes uterine artery embolization (UAE) for the treatment of fibroids:

When can I prepare for pregnancy after fibroid surgery

After surgery to remove fibroids, it is necessary to abandon pregnancy planning for at least six months. This time is necessary in order for the tissues on the uterus to heal well and subsequently be able to fully change during the entire period of gestation. This time can be extended up to a year if the operation was complicated, accompanied by large blood loss and the removal of many nodes.

Expert opinion

Daria Shirochina (obstetrician-gynecologist)

However, you should not delay the planning of pregnancy. After removal of the nodes, there is a high probability that new foci of myomatosis will appear. And if pregnancy is postponed for several years, it is possible that already new nodes will become an indication for another surgical intervention.

Preparation for pregnancy after removal of uterine fibroids

In general, approaches to planning pregnancy after removal of uterine fibroids do not differ from the usual ones. Recommendations are as follows:

For three months, start taking folic acid one tablet once a day with a partner.
A woman is examined by a gynecologist with a standard list of tests.
Undergo a complete examination of sexual partners for infections.
Be examined by narrow specialists if there are any chronic diseases, especially with taking pills - it may be necessary to replace them with others or stop using them altogether.

The course of pregnancy after removal of fibroids

How the pregnancy will proceed after the removal of fibroids depends largely on the diameters of the nodes, their location, the age of the woman and other related factors. However, all women are at increased risk for the following types of complications:

Incorrect implantation of the chorion and subsequent abnormal location of the child's place. As soon as the fetal egg descends into the uterine cavity, it begins to “seek” the most comfortable place for itself for subsequent implantation.

The areas of scars rarely “attract” the embryo to themselves, as a result, implantation occurs in atypical places - in the area of \u200b\u200bthe internal os (low placentation and later on the marginal or central location of the placenta), and sometimes in the cervix itself. The latter is a pathological condition and requires surgical treatment.

Threats of termination of pregnancy in the early and late stages. As the uterus grows, its muscle layers should increase evenly and, as it were, “stretch”. Scar areas are less prone to such transformations, so there is often a tone and a threat of miscarriage, up to the formation of retrochorial hematomas.
Malposition. Often, after removal of large nodes, the uterine cavity changes its shape. This forces the baby to take atypical positions - oblique, foot, pelvic, transverse. This does not affect the gestation process, only the course of childbirth.

Ruptures of the tissues of the uterus. The probability is higher, the deeper the tumor is located. On average, the frequency of uterine ruptures after laparotomic operations is no more than 3%, after laparoscopically - 7-10%. As a rule, this occurs in the third trimester, when the muscular layer of the uterus has to stretch as much as possible. A woman usually feels a sharp pain, which subsides.

After this, there may be a decrease in fetal movements due to its acute hypoxia. In some cases, massive intra-abdominal bleeding develops, threatening the woman's life.

Ingrown tissues of the placenta in the area of the scar. Perhaps in the event that the child's place is located in the area of previous surgical interventions, the vessels literally grow into defective tissues. This can be detected by ultrasound in the second or third trimester.

Watch this video about the treatment of fibroids and subsequent pregnancy planning:

Features of childbirth

The presence of cicatricial changes on the uterus always alarms doctors in terms of childbirth. Most often, they tend to conduct a planned caesarean section. This is due to the fact that it is impossible to find out how the uterus will contract after removal of the fibroids, even if the entire pregnancy proceeded safely.

Uterine rupture along the scar can occur at the peak of any contraction. The likelihood of this increases during attempts. First of all, the baby suffers - a state of acute hypoxia occurs. In such situations, childbirth does not always end well, and a fatal outcome for the fetus is not ruled out.

The natural conduct of labor is possible only if a small fibroid with a subserous location was removed, and the operation itself took place without opening the uterine cavity.

Pregnancy after removal of uterine fibroids is possible, but a woman's chances of various pathological gestation increase slightly. The planning process is no different from that of healthy women. You can think about pregnancy no earlier than four to six months after the operation - at the discretion of the operating doctor. Childbirth usually ends with a planned caesarean section.

The operation to remove uterine fibroids is a surgical procedure performed only in extreme cases: when all other methods are completely ineffective.

Even if modern surgical techniques are used, women's health is still at risk.

Depending on the stage at which the fibroid is located, its removal can be carried out in two main ways (methods):

Myomectomy. Myoma is excised with that part of the uterine cavity in which the inflamed nodes are located;

Hysterectomy or complete removal of the uterine cavity.

Laparoscopic myomectomy is performed under general anesthesia or by laparoscopy. Removal of uterine fibroids by laparoscopic method - partial removal of fibroids using a special tool - a laparoscope, which is inserted into the peritoneal cavity through small incisions;

laparotomy myomectomy - complete removal of fibroids through incisions on the abdominal wall;

hysteroscopic myomectomy - getting rid of fibroids using a gasteroscope (an instrument inserted through the vagina into the uterine cavity). Hysteroscopic myectomy is indicated when a submucous myoma is found, that is, growing in the lumen of the uterine cavity;

hysterectomy - complete, surgical removal of the body of the uterus;

uterine artery embolization - blocking the flow of blood through the uterine artery. This operation allows you to leave uterine fibroids without nutrition, which will lead the tumor to complete death;

FUS ablation (ablation) of uterine fibroids is a relatively new treatment method that uses focusing of ultrasound waves.

The laparoscopic method involves a procedure using a laparoscope and without large incisions in muscle tissue, which can significantly speed up the healing process.

the absence of postoperative pain, which allows you to do without taking analgesics;

a short stay in the hospital (usually two to three days);

absence of postoperative scars and adhesions;

quick return to normal life.

during pregnancy, uterine scars require additional monitoring of the woman;

the emergence of new nodes (relapses) is possible.

Pregnancy after removal of uterine fibroids is quite possible, since complete removal of the body of the uterus is not performed.

The abdominal operation has very serious consequences: after the incision of the abdominal wall, an ugly seam remains, which has to be hidden from prying eyes for the rest of your life.

In addition, a woman receives severe psychological trauma, however, one should be aware that maintaining health is impossible without this operation.

submucosal (submucosal) fibroids grow towards the lumen of the uterus and often lead to miscarriage;

subserous fibroids grow into the pelvic cavity, and not into the lumen of the uterus, which leads to menstrual irregularities.

Clipping of subserous nodes is carried out along a line located slightly above the stem (base) of the tumor. This is done in order not to create excessive tension at the site of suturing the tumor bed.

The advantage of the method lies in the dosed application of laser energy, which makes it possible to penetrate to a given depth and not affect neighboring tissues and organs.

After using the laser, there are no scars and sutures on the body of the uterus, which allows the woman to successfully become pregnant and give birth in the future.

the possibility of using laser therapy in nulliparous women;

outpatient operation;

the period of time required for the operation - 30 minutes;

postoperative period - two to three days;

normalization of reproductive and menstrual function.

you can not push, as this can lead to an increase in intrauterine pressure and subsequent rupture of the seams (do not eat products made from white flour);

eat mashed food, kissels, cereals);

mandatory restriction of physical activity is necessary (you can walk, but you can not practice physical activity);

avoid small household chores (cleaning, laundry);

you can not stay in the sun for a long time, go to the bath or sauna.

For example, if the operation was performed by an open method, then the recovery process is slower.

The patient is offered to limit physical activity, not forgetting that dosed walking can only bring benefits and will contribute to accelerated healing.

In such cases, we should not forget that the desire to recover is the main secret of a speedy recovery.

A good result in the postoperative recovery of the female body shows a respiratory device Frolov Phenomenon.

The Frolov Phenomenon simulator today is the only medical device that allows you to activate the hidden reserves of the female body, at the same time:

triggering the mechanism of tissue repair at the cellular level;

activating metabolic processes.

In addition, it is known that endogenous respiration has a beneficial effect on the female psycho-emotional sphere.

The Frolov Phenomenon device allows you to do without medical manipulations and expensive drugs, and this, in turn, quickly returns her to her usual life and completely restores the health of her reproductive system, while reducing the possibility of a relapse of the disease.

Let's say the main thing right away: removal of the uterus or its fibroids is not a direct contraindication for having sex.

Pain or discomfort during sexual intercourse only indicate the unpreparedness of the female body for a normal sexual life.

In such cases, only the surgeon who operated on you can become your best adviser. Only he personally knows your physical data and can tell you what complications and negative consequences may haunt you.

Maybe it's best for you to use special lubricants to facilitate sexual intercourse, or maybe it's best for you to wait a certain time so that nothing bothers you later.

After removal of the uterus, it is very important to use contraceptives correctly. In this case, you also need to consult your doctor.

In such cases, contraception is not needed at all, since the removal of the uterus brings the woman into a state of menopause. Many women even feel satisfaction from the fact that now you can not be afraid of a sudden pregnancy.

Moreover, many women after the operation have not lost their ability to experience sexual orgasm.

If the uterus remained in a reproductive state (only the fibroids were removed), then the woman, of course, should resort to contraception to protect herself from unwanted pregnancy.

After surgery to remove uterine fibroids, you can usually have sex after a month and a half, and planning a pregnancy can be done after about nine months to one year, depending on the general condition of your body.

The diagnosis of "uterine fibroids" during the planning of a child can scare and lead to despair. Indeed, in fact, it is a tumor, although benign, but located in the place where the child grows and develops for nine very important months. And how can they be compatible? pregnancy and fibroids. Doubts about this are quite appropriate and expected, and only a doctor can dispel or confirm them during a personal examination.

As mentioned above, fibroids are a benign change in the muscular layer of the uterus, or rather, the growth of quite ordinary muscle cells as a result of improper division. Recent studies show that fibroids are usually not prone to malignant transformation. The probability of this is only 0.3%. As much as the rest of the cells of the uterus.

This point is very important in the disclosure of this topic. After all, it is advisable for a woman who is about to become pregnant if there are fibroids in the uterus to find out about all the problems that she may encounter.

Unnaturally increased uterine tone during pregnancy, caused by myomatous nodes.

Violation of the blood supply to fibroids as the gestational age increases and the walls of the uterus stretch, leading to inflammation of the node and even to its disintegration. In addition, this condition is accompanied by increased uterine tone and serious pain.

Attachment of the placenta in the area of the location of the myomatous node and the violation of its correct formation, which can cause miscarriage or fading of pregnancy and fetoplacental insufficiency or premature detachment of the placenta at later stages in the early stages.

No doctor can accurately predict how the nodes will behave during pregnancy. Some of them increase, others, on the contrary, decrease and even cease to be visualized on ultrasound. However, most often after childbirth, all fibroids return to their previous size. Therefore, pregnancy in combination with fibroids requires increased attention of the attending physician and the pregnant woman herself, since measures to prevent uterine tone and destruction of fibroids in such situations are quite important. It follows from this that the sooner a woman gets up not accounting, the better for her.

healthy long sleep;

lack of any physical activity and stress;

additional ultrasound of myomatous nodes and placenta, if it is located on the node or next to it.

In the case of inflammation of the fibroids, it is very important to quickly detect this pathology, since further treatment depends on it - medical or surgical. The main thing is to restore the blood supply to the fibroids, for this they often resort to the same means that are prescribed for violations of placental metabolism. In addition, drugs are used to eliminate the tone, pain or bleeding, if necessary.

The help of a surgeon is usually required in very rare cases, when conservative treatment is ineffective and the fibroids continue to collapse. Surgery to remove fibroids although it is quite easily tolerated by the laparoscopy method, it is performed according to absolute indications, since it carries a certain risk of abortion. At the same time, it is believed that the risk to a woman's health is minimal.

Laparoscopy is the most suitable method for removing fibroids during pregnancy. Recommended favorable terms for removal - starting from the 16th week. After 32 weeks, the uterus becomes too large for such an operation.

Childbirth with myoma also requires special attention. For example, it happens that a large fibroid is located in the region of the cervix. In this case, a barrier is created for the child and a caesarean section is more often required for delivery.

Also, due to myomatous nodes, there is a slightly higher probability of disruption of the coordinated work of the muscles of the uterus during contractions or weakening of labor. Possibly incomplete separation of the placenta.

In addition, a uterus with multiple nodes may take longer to return to its normal state than a uterus without fibroids.

Quite common is the question is it possible to get pregnant with fibroids? Submucosal fibroids, growing, in fact, on the inner lining of the uterus in its cavity, can become a serious obstacle to conception. For example, they can prevent sperm from reaching an egg or a fertilized egg from implanting in the endometrium. In addition, it is known that large fibroids are able to squeeze the fallopian tubes.

In turn, small nodules (less than 2 cm) located in the muscular layer of the uterus rarely have a negative effect on embryo implantation. They are the safest among all types of fibroids. Most often, the course of pregnancy does not have any features. And if there are no other reproductive health problems, then conception is highly likely. However, in any case, it is highly desirable to consult a surgeon before planning, since pregnancy may not be recommended for some types of fibroids. These are the so-called pedunculated nodes, prone to twisting and malnutrition, nodes located in the submucosal layer of the uterus and large fibroids any localization, because the larger the size of the fibroids, the higher the risk of preterm birth.

In order to avoid various complications associated with problematic fibroids during pregnancy, doctors recommend their removal after prior therapy aimed at reducing the size of fibroids. Modern technologies make it possible to achieve this without traumatic manipulations and removal of the entire uterus. After removal of uterine fibroids pregnancy planning is allowed on average after about 6 months.

Myoma is a benign tumor. The main reason for its formation is a hormonal imbalance, or rather a high level of estrogen. The probability of degeneration of fibroids from benign to malignant is 0.3%. In most cases, these are tumors of various sizes and shapes. In 5%, it develops in the cervix, and in the rest - in the body of the uterus.

Such a diagnosis for a woman is a shock, especially if she is going to get pregnant for the first time. Despite this, the vast majority of women become mothers safely and give birth to healthy babies.

Small uterine fibroids do not create any special problems for conceiving and bearing a child. How to treat uterine fibroids with herbs can be found in this article.

Uterine fibroids and pregnancy are quite compatible concepts. AT

if the fibroid is small (3-4 cm) and located outside the uterus, the chance of getting pregnant is quite high. However, there is a high risk of abortion, violation of the contractile function of the uterus during labor and other complications. It is impossible to conceive a child only in such cases if:

the tumor has formed in the uterine cavity and interferes with the attachment of the fetal egg;

education blocks the entrance to the fallopian tubes and this prevents the sperm from meeting with the egg.

Under favorable conditions, you can get pregnant naturally and with the help of IVF. The likelihood of conception will decrease if a woman has concomitant diseases of the internal genital organs: endometrial polyps, endometriosis, polycystic ovaries and other chronic diseases.

For the successful development of the fetus, a woman should be registered with a doctor as soon as possible. Depending on the size of the neoplasm and related factors, the gynecologist will determine further actions. Whether or not to remove the tumor will depend on the size of the nodule.

The next stage after the conception of a child is the preservation of pregnancy. After all, there is a real threat of abortion. A benign tumor is dangerous because:

Myomatous nodes can provoke an increase in the tone of the uterus;

With an increase in the gestational age, the walls of the uterus are stretched and the blood supply to the tumor is disrupted. This can lead to inflammation of the fibroids, accompanied by severe pain and increased tone of the uterus;

If the fetal egg is attached to the location of the fibroids, the likelihood that the placenta will form incorrectly increases. This can be the cause of missed pregnancy, fetoplacental insufficiency and spontaneous abortion. In the 3rd trimester, premature detachment of the placenta may occur.

No one knows what will happen to the miotic nodes during pregnancy, even an experienced gynecologist. Some neoplasms resolve, the second decrease, and the third, on the contrary, only increase in size. It is known that after childbirth, tumors acquire their original dimensions.

The sooner a woman with fibroids sees a doctor and gets registered, the better. Pregnant women with such a disease require increased medical attention. She may be prescribed a course of treatment in order to get rid of the formation and undergo prophylaxis for increasing the tone of the uterus. Mostly with this pathology, children are born by caesarean section.

additionally undergo ultrasound of the tumor and placenta;

completely avoid physical and psychological stress;

rest more.

With inflammation of the fibroids, you should both consult a doctor and carry out medical, if necessary, and surgical treatment. Medications are prescribed to reduce pain and bleeding, reduce muscle tone. To restore the blood supply to the tumor, drugs are prescribed to regulate placental metabolism.

With the ineffectiveness of drug treatment, the woman undergoes surgery. Its essence lies in the removal of the node using the laparoscopic method. Typically, such operations are performed from 16 to 32 weeks of pregnancy. There is also a small risk of miscarriage.

By itself, a benign tumor is not the cause of infertility. But if all the established causes of infertility are identified, removing the tumor will significantly increase the likelihood of conception. This applies to fibroids, the size of which is not more than 12 weeks. It is more difficult to maintain the ability to bear a child after the removal of a large tumor. The operation may be complicated by bleeding and, in rare cases, even removal of the uterus. If the operation was successful, you can plan a pregnancy in a year. It all depends on the size of the node, the nature of the operation and postoperative complications.

The presence of fibroids is a factor complicating the course of childbirth. Recommended preliminary hospitalization in the maternity ward for preparation for a period of 37-38 weeks of pregnancy. In women with small subserous or intramural nodules without comorbidities, vaginal delivery is preferred.

low location of nodes that prevent the opening of the cervix and the advancement of the fetus;

multiple nodes or a large size of a single formation (diameter 10 cm or more);

a scar on the uterus after myomectomy, the consistency of which indicates the risk of rupture;

malnutrition of the node, leading to necrotic, inflammatory and degenerative changes in unchanged areas of the uterus (metritis);

suspicion of degeneration or necrosis of fibroids (rapid growth, large size, soft consistency, local pain, anemia);

combination with other diseases and complications of pregnancy;

Placental polyp during pregnancy and after childbirth, as a complication, needs to be observed and treated by a specialist. Find out how thick the endometrium should be here.

There may be complications in childbirth, such as untimely outpouring of water, anomalies in the contractile activity of the uterus, tight attachment of the placenta, hypotonic bleeding, which require emergency delivery. Often a caesarean section in the presence of navogenesis ends with the removal of the node or organ completely.

A woman planning to conceive a child should be regularly observed by a doctor and take preventive measures to form new tumors with the help of medications. Timely access to a doctor, attention to one's health and a great desire to have a child are the main criteria for successful conception, normal gestation and timely delivery.