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Posted by Dr. Deepti Asthana on 29-07-2026
To-be-mothers on the road to a happy motherhood are often saddened by the detection of uterine fibroids during scans in their pregnancy. It can be scary for many and be a cause of nightmares. Fibroids also cause infertility in a few cases.
Dr. Deepti Asthana, one of the best gynecologist and obstetrician in Gurgaon, is well known for the treatment of women detected with fibroids during pregnancy or having infertility problems due to fibroids.
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Fibroids are non-cancerous growths, lining the muscle of the uterus. They are also called Myomas of the uterus.
Their size can be as small as less than 1 inch to around 8 inches or more.
They can grow in clusters or in an isolated manner.
Almost 77% of women in the childbearing age group might have this condition, without even knowing about it.
There is a very rare possibility that they might convert into cancerous tumors.
Depending on their location inside the uterus, they are classified as submucosal, intramural and subserosal fibroids. They can be located at the fundus, body or at the cervix of the uterus. Two women can have fibroids of exactly the same size and have completely different pregnancies, because position determines whether the growth touches the cavity where the baby develops.
| Type | Where it lies | What it usually means |
|---|---|---|
| Submucosal | In the inner wall of the uterus, bulging into the cavity | Most likely to affect implantation and cause heavy bleeding |
| Intramural | Within the muscle of the uterus | Can alter the shape of the cavity if large |
| Subserosal | Just towards the outer surface of the uterus | Least likely to interfere with pregnancy; may cause pressure symptoms |
They often cause symptoms like heavy bleeding during periods accompanied by pain, irregular bowel movements or even pain while passing urine. Many women, however, have no symptoms whatsoever, and learn about a fibroid for the first time at their dating scan.
The exact trigger is still not fully understood. What is well established is that fibroids are hormone-dependent: they grow under the influence of oestrogen and progesterone, which is why they appear during the reproductive years, enlarge in pregnancy, and shrink after menopause when hormone levels fall away.
Certain factors make them more likely, though none of them are a cause for alarm on their own:
Ask for the number, the size in centimetres and the position of each fibroid to be written into your report. Those three details are what your obstetrician will use to plan the rest of your pregnancy, and having them recorded early gives a baseline to compare later scans against.
During pregnancy various hormones are at their peak, one of them being estrogen. Estrogen can make the pre-existing undetected fibroids grow larger in size during the initial three months of pregnancy.
It can lead to pain, bleeding and even miscarriages if the size of the fibroid is very large. Most fibroids, however, stay stable or grow only modestly, and a small fibroid rarely causes any trouble at all.
As the fetus starts to grow inside the womb, it puts pressure against the fibroid causing pain. A fibroid may undergo a process called red degeneration, when it outgrows its blood supply.
The pain may feel like severe cramping in the stomach or the pelvic region, and can be curbed by various medications prescribed by your gynecologist. It settles on its own over a few days with rest, fluids and pain relief, and it does not harm the baby.
Sometimes placental abruption is caused due to fibroids. This is a condition in which the placenta peels away from the uterine wall, which cuts the baby off from the supply of oxygen, blood and food from the mother.
This can lead to heavy bleeding and the mother can go into a state of shock. The risk is highest when the placenta has implanted directly over a fibroid, which is one of the things looked for on the anomaly scan.
It is worth keeping all of this in proportion. The majority of women who have a fibroid in pregnancy go on to have an uncomplicated pregnancy and a healthy baby. The purpose of monitoring is simply to catch the small number of problems early, while they are still easy to manage.
What changes at each stage of pregnancy, and what your obstetrician will be watching for.
| Stage | What can happen | What is done |
|---|---|---|
| First trimester | Oestrogen rises sharply and a fibroid may enlarge. Spotting and cramping are possible. | A dating scan records the number, size and position of each fibroid as a baseline. |
| Second trimester | Red degeneration is most common now. Pain can be sharp and localised, sometimes with a mild fever. | Rest, fluids and paracetamol. A growth scan checks the baby and the fibroid together. |
| Third trimester | Pressure symptoms increase. The baby may settle in a breech or transverse position. | Position and placental site are reviewed and the delivery plan is decided. |
| Labour and after | A low fibroid can obstruct labour. The uterus may contract less efficiently after birth. | Delivery is planned in advance and blood loss is watched closely afterwards. |
Treatment during pregnancy is almost entirely about careful observation and symptom relief. The fibroid itself is left alone.
Scans are repeated through the pregnancy to track the size of the fibroid, the growth of the baby and the position of the placenta in relation to the fibroid.
Paracetamol is the first choice. Anti-inflammatory medicines are used sparingly and are avoided altogether in the third trimester because of their effect on the baby's circulation.
Most episodes of degeneration pain settle within three to seven days with rest and adequate fluids. Admission is only needed when the pain is severe or the diagnosis is uncertain.
Women who had heavy periods before conceiving often start pregnancy with low iron stores. Correcting this early matters, because fibroids raise the risk of bleeding at delivery.
Removing a fibroid during pregnancy carries a high risk of bleeding and is reserved for rare situations. In nearly every case the fibroid is left alone until after delivery.
The route of delivery is decided from the position of the fibroid, the presentation of the baby and the site of the placenta, rather than from the size of the fibroid alone.
Mild cramping and a heaviness low in the abdomen are common and usually harmless. The following need to be assessed without waiting for your next appointment.
If in doubt, call. It is always better to be examined and reassured than to wait at home wondering.
Fibroids change both the shape of the uterus and the environment inside it, and either can stand in the way of conception.
If a fibroid is known about before conceiving, there is time to decide calmly whether anything needs doing first.
For most women the fibroid quietly becomes a non-issue once the pregnancy hormones settle.
Dr. Deepti Asthana is a highly distinguished Obstetrician and Gynecologist with over 14 years of clinical expertise. Holding an MBBS from KGMC, Lucknow, and an MS from SMS Medical College, Jaipur, she currently serves as a Consultant at Fortis Memorial Research Institute, Gurgaon, and is the Director of Kalosa Aesthetics.
A critical focus of Dr. Asthana’s practice is the complex management of uterine fibroids and pregnancy. While fibroids are common noncancerous growths, navigating uterine fibroids and pregnancy requires advanced clinical precision to prevent complications such as preterm labor, severe pain, or placental abruption. Utilizing her specialized training in high-risk obstetrics and minimally invasive surgery, Dr. Asthana meticulously monitors fibroid growth and location throughout all trimesters to safeguard maternal and fetal health.
Recognising that patient care, a gentle bedside manner and precise clinical outcomes come first, Dr Deepti Asthana takes pride in being a compassionate doctor who always puts her patients’ needs first.
View AllI am very satisfied and happy with the results of my treatment. She is an amazing doctor — very kind and humble. She made me understand what was the right choice for me even before the procedure, and I am glad I chose to trust her. The staff is also very polite and cooperative.
At first I was a little anxious, but after meeting the staff and Dr Asthana herself I felt reassured. After the procedure I was very satisfied with the outcome and the care I received throughout.
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Uterine fibroids are common, benign tumors of the uterus. They can cause a variety of symptoms, depending on their size and location. Many women with uterine fibroids have no symptoms at all.
Short expert insights on women’s health, pregnancy care and gynecological treatments.
Fibroids are non-cancerous growths lining the muscle of the uterus, also called myomas. There is a very rare possibility that they might convert into cancerous tumors, which is why a fibroid that grows rapidly, particularly after menopause, is always evaluated promptly.
Studies have shown that almost 77% of the women in the childbearing age group might have this condition, without even knowing about it. Most are small, cause no symptoms at all, and are found by chance during a scan done for another reason.
During pregnancy various hormones are at their peak, one of them being estrogen. Estrogen can make pre-existing undetected fibroids grow larger in size during the initial three months of pregnancy. Growth usually slows or stops after the first trimester.
Yes, in many cases. What matters is where the fibroid sits rather than how big it is. A fibroid high on the body of the uterus usually allows a normal delivery, while one lying low near the cervix can obstruct the birth canal and makes a caesarean more likely.
Many times doctors advise a caesarean section for delivering the baby, as the fibroid might hinder the birth canal during labour. Fibroids may also not allow the baby to come into a head down position for a normal vaginal delivery. The decision is made in the third trimester, once the position of the baby and the fibroid are both clear.
Red degeneration pain is distressing but does not harm the baby directly. It settles over several days with rest, fluids and pain relief that is safe in pregnancy. Pain that is severe, constant or accompanied by bleeding or fever should always be assessed the same day.
Almost never. The uterus carries a very rich blood supply in pregnancy and surgery risks heavy bleeding and loss of the pregnancy. In nearly every case the fibroid is monitored through the pregnancy and any treatment is planned for afterwards.
Post-delivery the fibroids miraculously shrink in 70% of women, as the level of estrogen drops down. A scan at around three months after birth shows the true size once the uterus has involuted.
A submucosal fibroid bulging into the cavity can interfere with implantation and is associated with early pregnancy loss. Removing it, usually through the cervix without any cut on the abdomen, improves the outlook in women who have had repeated miscarriages.
After a laparoscopic or open myomectomy, conception is generally advised about six months later, once the scar in the uterine muscle has healed properly. After a hysteroscopic removal the wait is much shorter, usually one to two months.