Understanding Fibroids and Pregnancy: A Patient's Experience

Question
Thank you for your answer on 4 childbirth 01/08/2008. I need to ask you another question. I had brown spotting at 10 weeks and the GP said that the placenta was over the cervics, I was restless 2wks later and went to the state hospital for a check-up that GP said that it is a Myoma attached to the placenta(measuring 5,8x4,2cm) and certified me as a high risk pregnancy, after all not satisfied and saw a Gynae whom did a amnio-results the baby is fine but there is a fibroid (didn't say where it was) shortly after we moved and I have to go to the state hospital again, the gyne there said I should get all my reports and then return I am now 34 weeks. My question is should I give normal birth? Will the placenta release normal and what about the myoma? Will the placenta not tear or the myoma bleed? Will it make labour more intense and painfull? Should I rather opp for a ceasar. I dont want to go through labour and then still end up for an emergency opp as the gynae's are not always available at the state hospitals. Please if you could help I would appreciate

Answer
A myoma during pregnancy does increase your risk for preterm labor, placenta abruption, and postpartum hemmorrhage.  You say you have been certified as a high-risk pregnancy, but you also need to be sure you are seeing a perinatologist, an obstetrician who specializes only in high-risk pregnancies.  This type of doctor can follow you more closely and monitor you during labor and delivery.  Unless you have an abruption before your baby is delivered, you will probably be okay with a vaginal delivery with monitoring, but you need to consult with a perinatalogist to be sure.