Pregnancy and Disease

Description

The following is a discussion of the primary diseases and conditions associated with pregnancy. (It is not intended to be definitive).


Uterine myoma

# The uterus is made of hard and strong muscle. A uterine myoma is a hard benign growth that forms on this muscle layer. Most myomas form on the corpus uteri, but occasionally they form around the cervical duct. Myomas are not found in teenagers, but the incidence rate increases with age as women enter their 20s, 30s, and 40s. The rate also increases among women who have pregnancies later in life, or women who had an uneventful first pregnancy, but whose second pregnancy is marked by the discovery of a myoma.
# A myoma can be a cause of infertility in women who previously had a successful pregnancy but several years later are unable to conceive. If the myoma interferes with conception, a myomectomy is performed. Many women do become pregnant after this surgery.
# Usually, a myoma will not interfere with a pregnancy; as the fact that a woman is pregnant with a myoma, means that the myoma is small. Generally, when a myoma becomes larger, the amount of menstruation increases and cramps become severe. This is especially true in the case of myoma uteri submucosa, myomas that form on the inside of the uterus. This type of myoma can cause infertility or miscarriage.
# If a woman is somehow pregnant and a large myoma is present, the myoma can cause abnormalities with the position of the fetus. Normally after 30 weeks into pregnancy, the fetus is positioned head down, but if a myoma interferes, the baby can be reversed. This can be detected early using ultrasound. Although the placenta and fetus may be in normal positions, a cesarean section is done if a myoma interferes with natural birth.


Ovarian cysts

Sometimes it is discovered during early prenatal examinations that the ovaries are swollen. But most of the time this indicates a luteal cyst. Despite the presence of a luteal cyst, the ovaries almost never grow larger than 6 cm, and around the 4th month when the placenta is complete, the cyst should shrink. No special treatment is necessary when a luteal cyst is diagnosed by ultrasound or other methods.

# Surgery is only necessary when a cyst grows larger than 6 cm, and when complications like torsion or rupture occur.
# Surgery does not affect the baby.

After the 4th month, when the placenta is complete, the problematic ovary is removed. By this time, hormones needed to continue pregnancy are secreted from the placenta. After childbirth, ovulation occurs regularly every month so pregnancy is possible again. Generally, surgery does not cause miscarriages or premature births.


Endometriosis

The endometrium is the layer covering the inside of the uterus. Endometriosis is when similar tissue to the endometrium forms inside the uterine muscle, outside or behind the uterus, or inside ovaries. The cause is unknown. The symptoms vary depending on where it occurs, but generally cramps and menstrual irregularity accompany it. If endometriosis is severe, organs can adhere inside the pelvis and cause infertility. But pregnancy indicates that the symptoms are light. If it is severe enough to affect pregnancy, the affected part of the ovary can be surgically removed. Surgery can be done during pregnancy without the danger of miscarriage and premature birth.
# Symptoms may become lighter with pregnancy


Uterine cancer

# Different measures can be taken depending on whether children are wanted or not.
# There are 2 types of uterine cancer-uterine body cancer and uterine cervical cancer. With uterine body cancer, pregnancy is impossible; but with uterine cervical cancer, it is possible. Uterocervical (cervix) cancer has almost no subjective symptoms in the early stages, so early detection is difficult unless examined. If it is discovered before it becomes cancerous, it can be treated by operating on the cervix or by laser irradiation. A decision must be made to delay surgery (of course, depending on the severity of the cancer) if a child is wanted, or go in to surgery immediately for the mother's future.
# Uterine cancer can be confined to the endometrium or invasive, which has a very low survival rate. (See detailed sections on uterine cancer.)


Vaginitis

Normally infection and inflammation do not occur easily inside the vagina because it is acidic, but pregnancy changes vaginal flora and candida or Trichomonas can easily cause vaginitis. With candida vaginitis, there is an increase in cheese-like mucous and itching around the pudendum. With Trichomonas vaginitis, there is an increase in yellow, puss-like mucous with foaming and itching around the pudendum, and burning pain.