low lying fibroid 8x6cm, 33 wks worried about childbirth - any advice?

[sarns]

Hi, so sorry about the long post - i am very nervous and want advise on dealing with fibroid in delivery as well as the nhs system so i am outlinining this in great detail in hope someone can advise me on how to deal with my dr's and hopefully get info out of them.

I am 33 weeks pregnant with several fibroids, an orange, 2 lemons, and a few eggs as the sonographers have joked. one of which is low lying over 8cm and baby's head is just above it, he is head down at the moment. I am very confused by the antenatal staff i have been seeing and would really like advise from women who have delivered with similar fibroid positioning.

this is my first pregnancy and i have had terrible abdominal pain including suspected degeneration, though i didnt go to hospital when maybe i should have done as i may have been taken more seriously later on, if i wasnt bleeding i thought i wouldnt trouble them. It started at 9 weeks with pain and heavy bleeding, which during an emergency scan was diagnosed as fibroids, though 6cm at the time was the low one. I had a referral to an obs consultant, mr ash at st thomas's, at 11 weeks who said if i make it that far he will see me at 37 weeks, though i am at risk of pre term labour and pph.

my 13 weeks scan showed the fibroid had not moved and was still 6cm, with a few others cropping up in the scan. at 16 weeks i went into a really painful spell, which got me really worried for baby, and by the time i could move again a week later i decided to go for a private re-assurance scan for £100, it was only meant to be a check up on baby as i didnt want to bother nhs as i was better by then. the private consultant however popped his head around the door and said my case was very interesting, i should get more monitoring for sure, baby was fine and a c section was safest delivery in light of the fibroid position being so low and close to the birth canal. he told me to come back at 30 weeks but i simply can't afford it.

at 20 weeks i had my anomily scan, and the sonograper asked me to let my dr know that i should have another scan as the fibroid is still very close to birth canal, i said i wasnt due to see one until 37 weeks so she booked me in for a 32 week scan herself but said i should get seen by a dr if i can.

at this point i went to my gp with my concerns, my community midwife wouldnt return my calls and i had only 1 meeting with her by this stage. I asked to be referred to a fibroids specailist by name, mr mascarenas also st thomas, who operated on my friends fibroids. the appointment was booked in by one of the lovely midwives at st thomas who seemed very concerned at 24 weeks. on the day, he wouldnt actually see me, though i saw him read my notes i believe (my friend described him to me later), and i was given what seemed like a standrad message by one of his junior dr's that there is nothing they can do and i just need to take paracetemol and codine if i cant sleep, go to hospital with any more bleeding or regular contractions and vaginal delivery would be most likely. I was concerned about not being able to see someone before 37 weeks as i was at risk of preterm labour and he said i should ask my midwife to book in at 32 weeks with mr ash.

my 32 week scan showed the fibroid has grown to 8cm, and baby's head was above it. the sonographer was also a midwife and she said in her opinion it looked like a c-section. i assumed my meeting later in the week with mr ash would be to discuss the details of delivery in light of all the scan results showing it was low and slightly bigger. i am by now very worried about delivery complications, have a read a fair bit on line, probably not so wise.

that appointment was today, and he wasnt available, i was seen by a junior dr who told me that baby's head would likely descend past the fibroid in which case a c section would not be appropriate wheni described my situation and asked if fibroid or vaginal delivery were best in my case. when i asked about if the fibroid may flare up during vaginal delivery or if it could cause a more complicated labour, she seemed to discuss something not relevant, about fibroids inside the womb, which i dont have, mine are intramural. i asked her if she had read my notes, which she said she had, but then opneed the book and started going through the notes then. i said i wasnt happy with the advise she was giving me as it didnt pertain to my particular case, but a generic message about fibroids and she offered a second opinion. a registrar then came in, with the jnr dr stood cross armed behind her, told me it would most likely be fine for vaginal brith and that 100% of women with fibroids deliver vaginally in her experience without any medical intervention - which is completely far fetched - or i am being unreasonable? i got the very distinct impression they were fobbing me off and said they couldnt make any further assesments on the birth until 38 or 39 weeks. unfortunately the notes that were written by the jnr dr at the end of the visit were pretty negative, 1st line reading i am very unhappy with my antenatal care and i was insisting on an elective c-section - which really wasnt the case, i just wanted to discuss how my fibriod will affect birth either way.

on my way out i bumped into the sonograoher midwife who did my 32 week scan and asked her why they are reluctnat to discuss delivery with me when she was able to say it looked like a c section was more likely, she said she didnt know but sometimes they leave it until the last minute. she arranged an appointment for next week with mr ash for me saying i wasnt being a bother but i should really be seeing him to discuss this if i still have questions.

does anyone have experiences of childbrith with low lying friboids they would like to share? and any advise on how to approach my discussion with mr ash next week, he is rather an abrupt man. my preference is for a c-setion if the labour is likely to be complication or dysfuntional, which i have read in british medical journal that there is a medium risk that it will be. I am also worried my notes have pain in the ass written on them thanks to that jnr dr and i feel i am not being taken seriously bythe dr's in general, the midwives and sonographers have been pushing through my care more that my community midwife and the dr's seems to read my notes and switch off.

any advise much much appreciated....

thanks for reading

[Montifer]

Sorry to hear you're having a stressful time. It's really hard when you haven't done any of this before and don't feel like you are being listened to by Drs.

I had a low lying fibroid, although bit smaller than yours I think, was also concerned after doing scary reading on internet.
I was lucky not to have pain with it and also had a nice obstetrician who basically said all along "Wait until 34 week scan and we can see where it's up to", she advised me to fully prepare for a vaginal delivery but keep in mind that I would need to be closely monitored during labour and an emergency C section could be on the cards if labour didn't progress satisfactorily.
As it turned out the sonographer couldn't find the fibroid at 34 scan! Baby's head had descended and it (fibroid) was obscured somewhere in the depths.
I thankfully went on to have a remarkably easy delivery.
I appreciate that I was very lucky and that I had an easy time as fibroids go.

I would recommend writing down any concerns / issues /fears that you want to discuss with the Consultant to make sure all of your questions are answered and you are able to plan for your best and worse case scenarios.

Hope all goes well for you

[sarns]

thanks you for your story, i have calmed down a fair bit since yesterday and am hoping to stay that way for my meeting next week. I just get the feeling there is a system which needs to be negotiated to get the best care from these dr's and your individual case doesnt seem to be considered. congradulations on your baby and hope all goes well for you too.

[mears]

sarns - your care certainly seems to be fragmented. As a midwife I see women on a regular basis who have fibroids and no problems with vaginal delivery. As long as the fibroid is not infront of the baby's head causing problems with head descent, there should be no reason for a CS. If you go into labour and it becomes dysfuctional, then a CS might need to be done, but there is no way of predicting that. You may be at higher risk of post partum maehorrhage, whether delivery is vaginal or CS, but treatment will be instigated for that if needed. Much better to avoid surgical deliveryif possible. Hopefully you will be able to discuss all this next week. Make sure you srite down all the questions you have. Can your partner go to the appointment with you?

[TuttiFrutti]

This is so difficult to give any advice on because it's entirely technical. Either the fibroids will impede the birth and you will need a cs, or they won't. It depends totally on their size and position. Only a doctor can tell you that, and it sounds as if you haven't had the most brilliant medical advice so far.

For what it's worth: I tried to give birth naturally with fibroids, failed because they got in the way of the baby's head, and ended up with a nasty emergency cs. I also had a big haemorrhage which is apparently qutie common with fibroids.

My fibroids were undiagnosed before the birth as they hadn't been spotted on the scans. I thought at the time this was negligence by the hospital, but during my second pregnancy I realised that it was pretty much impossible to see them because they were on the back wall of the uterus, scans are only ever done from the front and as the baby grew it blocked out the view. Also, fibroids normally grow during pregnancy so they can be quite small at the time of your first scan and much larger (but sight of them could be blocked by baby) by your second scan.

Sorry, that probably isn't what you want to hear but I just wanted to tell you my experience. One third of all women have fibroids and they can have no effect on childbirth at all, or like me they can make natural birth an impossibility.

Is it out of the question for you to go private? It seems to me you need some really good medical advice from someone you cna have confidence in.

[sarns]

at the moment the fibroid seems to be partially blocking baby's exit, his head is on top of it at an angle and i have been told should his head negotiate past it in the next few weeks then vaginal birth will go ahead and that cant be assesed until later. should the head descend, i am wondering how the fibroid will react during vaginal birth considering it is in this awkward position, if it will flare up or worse, degenerate again, as a result of delivery. any ideas or expereince of similar?

[sarns]

thanks for the re-assurance by the way, appreciate your story even if its a bit scary

[MiniLlace]

Sarns - so sorry to hear about your care so far - Im in a similar position with fibroids but only at 2 weeks at the moment. I have known about them since my 8 week scan but it was only at my 20 week scan they noticed that one has lowered and grown and is now partially blocking the birth canal. I have an appointment booked at 32 weeks for a morning scan and an afternoon consultants appointment when apparently a decision will be made - however in light of your experience it will be interesting to see if any decision is actually made at that point. I too have had a v painful pregnancy at times but my midwife has told me its to be expected (great!) ..let us know how you get on I will be v interested to know - good luck!!

[MiniLlace]

sorry i meant im 25 weeks - my 5 button seemed to have got stuck!!

[dikkertjedap]

Hi, I only found out that I had a low lying fibroid when I had a private scan done and was advised (by private obstetrician) that because of the position (similar to yours but smaller fibroid) it would be best to have a managed third stage because a significant risk of PPH. Until then I'd wanted a home birth and the NHS consultant told me that that was ok, when I later told them about the private scan and the fibroid they still were not worried at all and thought I could give birth in the birthing centre. I did not want that as I wanted a managed third stage as advised by private obstetrician. In the end I had a ventouse delivery, fibroid was not an issue during delivery and had managed third stage.

I would keep insisting on talking to a consultant until they have fully answered your questions. Good luck.

[sarns]

i havent logged on for a while as i didnt want to think about the situation, it has really gotten me down so just been relaxing, thanks again for your messages. i thought i would reconfirm my appointment for tomorrow this afternoon, and lo and behold, my consultnat is not available to see me again, the appointment was with his team again as he is on holiday. i have begged for an appointment with him and they assured me that next week on the 14th he will be the only one to see me. fingers crossed....