Uterine fibroids and their effect on pregnancy: An updated review

Uterine fibroids, also known as leiomyomas, are the most common benign tumors of the female reproductive system, affecting a significant proportion of women of reproductive age. Although often asymptomatic, fibroids can have profound implications for pregnancy, influencing fertility, gestational outcomes, and delivery. The impact of fibroids on pregnancy depends on their size, number, and location within the uterus. Submucosal and intramural fibroids are particularly associated with implantation failure, recurrent pregnancy loss, and an increased risk of obstetric complications. Pregnant women with fibroids are at higher risk of miscarriage, preterm labor, fetal malpresentation, and cesarean delivery. Additionally, fibroids may contribute to placental abnormalities, such as placental abruption and placenta previa, which can lead to maternal and fetal morbidity. Hormonal changes during pregnancy can also cause fibroid growth, leading to pain, degeneration, and uterine contractility. Recent advancements in imaging techniques, such as ultrasound and magnetic resonance imaging (MRI), have improved the diagnosis and monitoring of fibroids during pregnancy. Management strategies depend on symptom severity, with conservative approaches preferred during gestation. However, in cases of severe pain or complications, medical or surgical interventions may be required. Emerging therapies, including minimally invasive procedures, offer promising options for women planning pregnancy. This review highlights recent findings on the relationship between uterine fibroids and pregnancy outcomes, emphasizing the need for individualized management strategies to optimize maternal and fetal health. Further research is essential to refine treatment approaches and improve reproductive outcomes in affected women.