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How does baby with dilated kidneys & me having fibroid affect L&D?

711 Views 10 Replies 7 Participants Last post by  cidercat
Hi all,
Im new here and I was told that I would get help if I posted this question here. Here's my story.

I am 22 wk pregnant and have been looking fwd to having a natural/unmedicated childbirth at a hospital here in Houston. Currently I am seeing an OB with high intervention/c-section rates and for whom IV and constant monitoring during labour are non-negotiable. I have also been doing some research about midwives delivering in hospitals around here. What more can I say but slim pickings.

Anyway, yesterday at my 22wk u/s the ob (not mine, another one) said the baby's kidneys look dilated (said baby was retaining urine) and maybe because I have been drinking too much juice/soda. I also have a fibroid. She said its on the edge of the cervix. I am supposed to go back in 6 weeks to have another look at these. By the way, only much later after coming home I thought about my sugar intake, and I hadnt had any sugary drinks since the previous afternoon, and cheerios for breakfast.

Now my question is: do any of these conditions affect my chances of having a natural childbirth? I'd like to have no interventions but if a baby with dilated kidneys goes in distress during labour generally then I'll have a c-section in a heartbeat. I just dont want to have an unnecessary one or just to fit the birth in with my OB's schedule. I have read up on the kidney thing and it appears sometimes it resolves by itself before the birth and in most cases pretty easy to fix after the birth. So I am not that worried about the problem per se (I cant do anything about it anyways, just pray), I just want to know how it will go during labour.

Also about the fibroid, I realize that they are pretty common. My SIL has had a VBAC with one and said it wasnt a problem. But I guess it would depend on how it grows or doesnt?

So, in the current circumstances, should I stay with the OB (who will likely get more antsy in the presence of these "complications") or make a switch to the hospital midwives? Or should I wait another 6 weeks to decide? I dont know if it will be easy to switch at 28wks.

Thanks a lot for any responses.
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It depends on the amount mof dilation the baby is having. There was a paper published 2 yrs ago )ave a copy ,but it's lent out) which says dilation up to a certain point has no significance.

The fibroid may be another matter. Depends on the size and whether it would interfere with the baby's progress through the birth canal.
The finding on the kidneys is a very common finding in earlier pregnancy, but nearly all of the time it ends up being completely fine.

Regarding the fibroid, like mothercat said, it depends on where it is, if it's on the outside of the uterus, etc.

I think in both cases you're likely to have a very non-eventful birth. Well, aside from the high-risk OB.
find a different OB- this group is not the best-- so you have slim pickings for a CNM- I know that there are some good docs down there- find one ASAP.
Thank you for your replies. I have been thinking about switching to a group with both Ob's and mw's called the "women's specialists of houston". I have read a few good things about them on some boards. The only prob (other than the "complications") is that the hospital that they deliver at is 40 min from our house (and who knows how much if i need to go in rush hour). But i think if I believe its going to be a pleasant enough experience I might as well not wait too long at home.
you will have plenty of time to make the hour of travel--- most women have 8-12 hrs of active labor and probably days of prodromal labor---
So, I have a baby who has multiple urinary tract anomalies. It was not detected on u/s, and it was not an issue for him until after he was born.

Had we seen it on u/s, there are two people who would be qualified to review it. A perinatologist and/or a pediatric urologist. But this is usually only done if your fluid level is questionable since the baby's kidneys control your fluid level.

Women's specialists is your best bet in Houston. There is at least one perinatologist who even do VBACs here in not UNvaginal birth friendly.

AND St. Luke's is right next door to Texas Children's should your baby actually have a urinary tract issue. And Women's could transport a baby to TCH.

And unless you need a perinatologist, you'd better switch soon, or you may not find someone. Especially at Women's Specialists.
I'm not a birth professional, BUT...I would not change birth plans for a little extra fluid on the kidneys. Some extra fluid is very common, not a problem and MOST of the time resolves on its own either before or after birth. (My son's did after he was about 6 months old.) It's found and talked about more now because of all the prenatal ultrasounds done. Unless there is something really wrong with his kidneys there's no reason you can't have the birth you want, where you want.

That said, in your situation I WOULD switch to the midwives or certain OBs at the Women's Specialists for many other reason. Good luck!
Thanks everyone. I really appreciate you taking the time out to reply. You have put my mind at ease and after one last meeting with my OB, I will probably try to switch within the next couple of weeks. Wish me luck!
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Fatima, good to see you made it over here! I hope that answered some of your questions. After looking at the more detailed description of your situation (and still knowing nothing about dilated kidneys or fibroids), it looks like changing your provider is the best bet. With your current OB, it sounds like you don't have a chance in heck of having a NCB, but with a more NCB-friendly provider you have a good chance, provided the fibroid cooperates.
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