Fibroids, pregnancy, and (pre-term) labour

[KikiShack]

I posted this in pregnancy but no replies so I'm hoping Childbirth can help...

Hi, Just looking for other people's experiences of pregnancy and labour with fibroids. I'm 37+2 so not pre-term anymore but I'm just on maternity leave today and am beginning to get excited about the baby finally arriving!

I have a few fibroids, some of which are quite big (they keep changing size but 2 or 3 are 8-10cmish). At my 36 week scan to assess a fibroid blocking my cervix I got the good news that it seems to have moved out the way so I'm hoping to get the go-ahead for natural birth.

So...just wondering if anyone else has been allowed to give birth naturally with big fibroids, whether it ended in an EMCS, and when labour started. I gather it can start early so I'm trying to gather some numbers and predict whether I have weeks of cooking ahead of me or if it's likely to start any day! I can't decide which I'd prefer, I'm looking forward to LO arriving and finding out the gender, but I'm also keen to enjoy the last few hours/days/weeks with just me and DP before everything gets turned upside down

I'm placeholding, if you don't mind.

I'm only 23+3, but I have 3 fibroids of similar sizes to yours, one of which is blocking my cervix. I spent the weekend in hospital with contractions/threatened labour, but luckily everything seems to have calmed right down again now.

So you can be my guide in what might happen to me!

Good luck!

I have looked after women with fibroids. In my experience, there is a higher likelihood of cs for slow/arrested progress. There is also a higher likelihood of post partum haemmorrhage with both vaginal and cs birth. Presumably this is because the fibroids in the muscle can interfere with the uterus contracting efficiently.

However, I have had plenty of completely normal births in the same situation. If the fibroid is not interfering with the cervix then it seems reasonable to labour with careful supervision and see how it goes. A bit like a vbac.

Is there a decent case for requesting ELCS, mayhew?

I utterly dread the thought of a CS (I wanted a home birth!) but I dread the thought of an EMCS even more. If I have to do it, I'd rather be in control.

mayhew that's good to hear from you as I'd heard bits and pieces from other sources, and my obs yesterday suggested a managed 3rd stage to speed up the uterus contracting to avoid just the kind of bleed you mention, also having a canular in place and the medicine for bleeds ready to go if necessary. Or maybe I mean the drug for speeding the placenta delivery up if it doesn't come out quickly on its own, I forget now!
I'm glad I've never had my heart set on a home birth as it seems this would not be a good idea for me...I like the idea of being carefully supervised by lots of experts.
toby at my 12 week and 20 week scans they couldn't see my cervix at all as it was completely blocked by this mega fibroid, but as the baby growth sped up I think my uterus dragged the fibroid up and out of the way. I haven't had any pain from the broids either, so not sure if I've had a luck escape or what. I'd been expecting some pain, but apart from some twinges at 14 weeks, as soon as I passed 16 weeks I've felt absolutely fine the whole time, just a bit full and clumsy always bumping into things with my protruding stomach.
I agree about preferring an elcs over an emcs, but I guess anyone no matter how fibroid-free and healthy they are can suddenly need an emcs for numerous reasons, so I don't see the risk of that as a reason for me not to try for vb. However I think balancing up the risks is something everyone should do for themselves so I'm not for a second trying to tell you what's best for you, only you know that. Good luck with it all.

I didn't even realise I had fibroids until my first scan. They've caused no problems until now. But now they're worried that one of them is degenerating, which is causing the pain and the contractions now. Apparently it could send me into labour at any time, but it's unlikely. I'm not allowed to lift anything or hoover, and I have to rest as much as possible.
Bummer :o

Good to know they've caused no real issues for you. And also that they've moved. That's very reassuring! My mw keeps reassuring me that they might move, but she has also warned me of the PPH risk. I'll see the consultant next week and find out what they're going to do with me!

Fingers crossed for your normal, completely uneventful VB.

EL CS is usually only planned if it looks like the fibroid will actually obstruct the labour or if a woman has had previous surgery on the uterus.

CS has a higher risk of heavy bleeding than normal birth so would not reduce that risk in fibroid women but might increase it.

An actively managed 3rd stage is normally recommended to reduce the risk of bleeding. A cannula in the hand would speed up any emergency management if it was needed.

This happened to me two huge fibroids one large one and one cervical one ended up with an irritated uterus and contractions from about 35 weeks head engaged so they assumed everything fine for VB but then the contractions broke my waters two weeks early, the cervical FB actually stopped it from opening more then 3 cms laboured for 26 hrs with synto drip then rushed in for EMCS

It was awful and we've never really spoken about it but I'm sharing because the EMCS was the calmest part and LO arrived safe and well so if it does go wrong dont be frightened of CS focus on your lovely LO when you do that you can do anything

Good Luck x

Oh, boutique, that sounds horrid. Glad everything turned out ok in the end.

I posted earlier in my pregnancy about similar anxieties. What kind of fibroids do you have OP? Mine was approx 10x11 and blocking cervix, was subserosal though at last scan it measured 7x8 (apparently this doesn't mean it's shrunk necessarily, baby might be making it hard to measure) they decided it was intramural. I asked the consultant about risk of early labour or IUGR, she said the kind of fibroid that is in the uterine cavity (with the baby) can cause problems but mine would be fine.

I'm sceptical about the consultant claims that once my fibroid had moved and baby shoved her way past (which has happened) that my risk of c section was same as anyone else, but I've decided to take this on board and hope for the best.

I'm set for a vaginal birth with managed 3rd stage. Have been told conflicting things - my notes say I'll need a transfusion of syntocinon after delivery for 2-4 hours to prevent (tiny additional risk of) bleeding, but the consultant I saw said just get a canula in your hand during labour so we can quickly administer any drugs should we need to. I'm still fine to use birth pool etc.

However I feel v v strongly that I don't want to agree to induction or augmentation of labour should these things become issues. Obviously in terms of bleeding risk vbirth is safer than c section, but equally, a planned c section (or calmer) is less risky than an emergency. Syntocinon is an additional pph risk factor, as is overdue baby, long labour, etc. So my plan is to go for v birth but stand my ground re interventions and insist on c section should these kind of problems arise.

I'm due tomorrow so will let you know how it goes!

I did find a useful review of various research, posted a link on a different thread if that helps - don't know how to find it on my phone.

I have fibroids, it looked like ds was playing basketball on my 20 week scan, he was holding onto one of tge fibroids.

Ds was born at 40+10 so no early labour for me. I had a normal birth with no issues at all.

This thread has reminded me that I must go and get myffibroids checked.