For fibroids less than 6 cm in diameter with no symptoms, regular prenatal care is recommended, with close monitoring for red degeneration of fibroids. The vast majority of these pregnant women can achieve vaginal delivery without special intervention.
For fibroids larger than 6 cm but still asymptomatic, close observation of fibroid growth is required during routine prenatal visits. After 37 weeks of gestation, the mode of delivery is determined based on the location of the fibroids, as well as fetal and maternal conditions. If fibroids are located in the lower uterine segment, they may cause obstruction of the birth canal and prevent the fetal head from engaging, in which case elective cesarean section is indicated. However, fibroids on the anterior wall of the lower uterine segment often ascend into the abdominal cavity as the uterus enlarges in late pregnancy, allowing the fetal head to descend and engage normally, permitting vaginal delivery.
Therefore, surgical intervention for pregnancy complicated by uterine fibroids is not recommended prematurely. Management should be conservative throughout most of pregnancy, with delivery planning delayed until near term to avoid unnecessary maternal and fetal risks.