Benign Tumor In The Cervix – Does Cervical Myoma Affects Pregnancy?

Benign Tumor In The Cervix – Does Cervical Myoma Affects Pregnancy?

Shilpa aged 35, was living a well-settled life for years. She was quite jovial and lively but not much cautious about her health. For a long time, she was complaining about pelvic pain, feeling of fullness in the abdomen and frequent urination. Meeting with the doctor she discovered that she was nurturing a large tumor in her cervix.

Since she was pregnant, the tumor led to c-section delivery though she was a good candidate for vaginal delivery. But the best part was that it was a benign mass and not cancerous. There are many such cases that remain obscure from us until and unless symptoms start creating troubles in our daily life. Tumor in the cervix or cervical myoma though a benign condition, can sometimes create serious complications.

Cervical Myoma

Tumor in the cervix or known by other names such as Fibroid of Cervix or Cervical Leiomyoma is a condition in which benign mass or tumor grows in the cervix. Myomas are smooth muscle tumors that can grow anywhere in the body but they are not cancerous.

Unlike uterine myomas, cervical myomas rarely occur and are usually painless and well circumscribed, meaning they are limited to a quantity or scope. Based on their location, they can be categorized into 3 different types:

  • Supravaginal Myoma of Cervix – Supravaginal is the uterine portion of the cervix. This is the most common type of cervical myoma.
  • Interstitial Myoma of Cervix – Also known as intramural myoma, this type of tumor grow within the muscular wall of the uterus.
  • Polypoidal Myoma of Cervix – These myomas can arise from the cervix and project into the vagina.

How common is Cervical Myoma?

The condition constitutes approximately 5-8 percent of all uterine myomas. Most commonly, about 95 percent cases of cervical myoma occur in women aged 30 and above. However, it may affect women of any age group. Cervical myomas also occur in pregnant women.

Causes and risk factors of Cervical Myoma

Medical experts aren’t sure what exactly causes cervical myoma but certain genetic factors might play a role in the development of these tumors. There are also certain risk factors that may contribute to the condition. These include:

  • Early menstruation
  • Family history of cervical myomas
  • Hormonal imbalance in the body
  • Obesity
  • Excessive consumption of alcohol

Signs and symptoms of Cervical Myoma

  • Majority of women with cervical myoma will not experience any symptoms until and unless the tumor is large in size. However, some women might complain:
  • Pelvic pain
  • Frequent urination (urinary incontinence)
  • Painful sex
  • Heavy menstrual bleeding
  • Enlargement of the lower abdomen
  • Constipation
  • Fertility problems

Cervical Myomas and Pregnancy

Since myomas or fibroids develop in the uterus, it affects pregnant women as well. If the growth is large, it may also cause preterm labor or adversely affect the position of the baby during labor. In worst cases, it can even cause miscarriage. Cesarean delivery might be the only option for the safety of the mother and the baby.
While most myomas won’t grow in size, one-third of them might grow during the first trimester. Once diagnosed through ultrasound, the pregnant woman is closely observed.

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Diagnosis of Cervical Myoma

Some cases can be diagnosed by the doctor merely on the physical evaluation of the pelvis. The doctor might also use other mediums to diagnose the condition.

  1. Ultrasound/CT Scan/MRI – These procedures are non-invasive. Where ultrasound uses high-frequency sound waves to create real-time images of the cervix and display on the monitor, CT scan, on the other hand, gives details on internal organs and blood vessels. MRI is an imaging technique that uses high powered magnetic fields to give more details about bones and internal structures of the abdomen and pelvis.
  2. Hysteroscopy – During hysteroscopy, a camera or probe will be inserted through the vagina and cervix to evaluate the uterine cavity.
  3. Hysterosalpingography – This procedure is typically suggested to women who have fertility issues. The test is performed by injecting a special dye and creating X-ray images to evaluate the uterus as well as the fallopian tubes.
  4. Biopsy – A biopsy is the most accurate way of diagnosing cervical myoma. The doctor will cut a small sample of the tumor and sent it to lab examination. The pathologist will examine the tissue under the microscope and report the findings. Biopsy is also helpful in ruling out other potentially harmful conditions.

How Cervical Myoma is Treated?

The treatment for cervical myoma depends on individual to individual, whether the woman is pregnant or have other health problems. Myomas which don’t cause any symptoms might not be treated and left for close monitoring. In some women, the tumor size may shrink after menopause.

However, in cases of symptoms hindering day to day activities, the doctor might suggest following treatment methods.

Medications

  1. Hormonal pills – Myomas usually grows in the presence of estrogen. Hormonal pills such as Gn-RH agonists block the production of estrogen and help in shrinking the tumor. These pills stop menstruation cycle temporarily.
  2. Tranexamic acid – This is a non-hormonal medication and is used to treat heavy bleeding during menstrual cycle.
  3. Other – The doctor may also advise non-steroidal anti-inflammatory medicines to give relief from pain. Other than this, medicines for fulfilling vitamin and iron deficiency may be recommended.

Surgical procedures

Following surgical procedures can be suggested depending on case to case:

  1. Myomectomy – In this procedure, a small cut is made through a slim instrument that removes the entire myoma or fibroid, leaving the uterus intact.
  2. Radical trachelectomy – This operation removes most part of the cervix, upper vaginal portion, and nearby lymph nodes. This procedure maintains the ability to get pregnant in future.
  3. Myolysis – This is a laparoscopic surgery that involves inserting a needle into the tumor and destroys it by passing electric current.
  4. Cryomyolysis – This technique is performed similarly to myolysis. The only substantial difference is that cryomyolysis freezes the tumor to death.
  5. Uterine artery embolization – In this technique, blood supply going to the fibroid is cut off. This shrinks the tumor and causes it to die.
  6. Endometrial ablation – A special instrument is passed in the uterus that passes high energy radio waves to destroy the uterine lining. This slows down menstruation.
  7. Hysterectomy – This procedure is usually the last hope for treating such conditions. Hysterectomy removes the entire uterus and takes away your ability to get pregnant in future.

Cervical myomas though a type of uterine fibroids, but the occurrence in women is less common. However, periodic screening is a must, especially if you are pregnant, else it can cause severe complications.