fibroid blocking exit- head cant engage

[glitterkitty]

Am nearly 36 weeks, and found out about a week ago that I still have a large fibroid (same size as baby's head!)low down.

Its currently preventing the baby's head from engaging. His head is squashed off the scale (small) because of it.

They have asked me to come in and have another scan at 37 weeks, to see if he has got heavier and forced himself past it.

However they didnt say what would happen then- I understand I might need a c-section but the consultant was umming & ahhing like they might still leave it for longer?

Two questions:

1. will it affect the baby because his head is squashed? The mw said not but I dont feel reassured...

2. I know the hospital are keen to get the cs rate down, and this makes me worried they are going to let me go into labour to see if I can do it naturally- then the baby might get distressed (or I might if I cant push him out!!!) and I'll have to end up having emergency cs- are they likely to suggest this?

To be honest I'd rather have an elective before I go into labour if he still hasnt engaged at next scan- I'm scared of going into labour and not being able to do it...

I might be being paranoid but its my first - and I dont feel like I trust the hospital (no offence sure they are very good)to do whats best for the baby- they have really banged on about cs rates in antenatal classes- but surely there are some circumstances where its safer to do that?

Any advice VERY gratefully recieved... am getting thoroughly stressed over the whole thing...

I went through exactly the same thing as you nearly 2 years ago, except the hospital failed to spot the fibroid on the scans. My fibroid was a bit smaller than yours, size of a tennis ball rather than baby's head, but still you'd think they would have seen it...

The result was that I failed to go into labour because the baby's head couldn't engage, so I was induced and then had a horrific long labour culminating in an emergency c-section. I wouldn't wish my experience on my worst enemy and I strongly advise you to go for an elective c-section. In fact, I don't understand how anyone could advise anything else. Vaginal birth just isn't possible with a physical obstruction below the baby's head.

I had a baby 6 weeks ago by elective c-section, and both the experience and the recovery were fantastic, and worlds away from my first birth.

Thanks- thats really helpful because its what I thought might happen if they let me go into labour.

I want (well, I wanted a natural birth actually but in the circs!) an elective cs but I'm just bloody worried they are going to make me have a go naturally- with exactly the result you had.

Can you say you want a cs in these circs or is it up to the consultant?

My friend had a large fibroid. As far as i know it wasn't in the way as such but her consultant recommended a c section - they also removed the fibroid at the same time (after the baby was delivered)

The same thing happened to me..

But my fibroid moved at the last minute (well between 2 scans)..

So one minute I was being told I HAD to have CS then 2 weeks later was told I couldn't as it would be too dangerous...

I went into a natural labour - but DD got stuck, so ended up with a GA CS... (after failed epidural)

No idea if she got stuck because of Fibroid or not, in fact I don't really know what happened in the end, except a lot of apologizes for failed epidural..

I would definately go down the Selective CS route if any change of the baby getting stuck etc...

Glitterkitty, if the fibroid is definitely in the way they will have to recommend a c-section. However, it's not always clear cut, partly because fibroids can move and partly because scans can't always see all of them, because a scan is only 2-D and is done only from the front whereas fibroids are 3-D and can be lurking round the back.

During this (second) pregnancy I was a bit shocked when a junior doctor tried to persuade me to try for a natural birth, because "the fibroids can't be seen very well, they might have shrunk, they might have moved". Who knows whether the hospital's c-s stats were at the back of her mind? I just stuck to my guns and insisted on an elective c-s. No idea if they'd have agreed if this had been my first pregnancy.

Fibroids can change size, but IME they only ever grow bigger during a pregnancy, because they are enlarged by the hormones.

It's quite unusual to cut them out during a c-section. Surgical removal is a big operation and not usually recommended.

glitterkitty,

I had a fibroid the size of a small melon and it was close to the cervix. I was at the UCH London and was told from the beginning that I was going to need an elective CS.
When I had Braxton Hicks contractions in week 28 I was briefly in another hospital and the doctor there said to me that he couldn't see why I shouldn't try for a natural birth.
I am glad that I didn't as the CS was very easy, painless and it healed very quickly. I left the hospital after 48h. It was a bit hard in the beginning to lift the baby but I am so glad I didn't TRY and then fail and end up with an emergency CS.
I would insist on CS.
Also, my ds was breech position due to the fibroid.
And they usually never take them out during the CS as the risk of bleeding is too high. For me they ordered 2 extra blood units in case I was going to loose too much blood. Luckily it wasn't needed.