Explain intramural, subserosal, and submucosal fibroids and their impacts on pregnancy and labour.

Intramural fibroids are located within the muscular wall of the uterus, known as the myometrium.

• Impact on Labour: These fibroids can interfere with the normal contractility of the uterine muscle during labour, potentially leading to dysfunctional labour or preterm labour due to increased uterine irritability.

Subserosal fibroids develop on the outer surface of the uterus, extending outwards into the pelvic cavity.

• Impact on Pregnancy: Large subserosal fibroids can exert pressure on surrounding organs such as the bladder (causing frequent micturition) or bowel, or they can lead to fetal malpresentation if they restrict uterine space.

Submucosal fibroids are situated directly beneath the uterine lining (endometrium) and protrude into the uterine cavity.

• Impact on Pregnancy: These fibroids can disrupt the uterine cavity, interfering with embryo implantation and placental development, which significantly increases the risk of recurrent miscarriages or infertility.