Narayana Health SRCC Children’s Hospital, Mumbai, Successfully Handles Complex Delivery Involving Large Uterine Fibroid in First-Time Mother

24^th  July  2025 – Mumbai : Narayana Health SRCC Children’s Hospital successfully  performed an elective caesarean section (LSCS) of a 37-year-old primigravida with a 13-cm intramural fibroid, a condition that is hugely surgical in nature. The complex delivery was expertly handled due to the hospital’s diligent multidisciplinary team and top-notch surgical preparedness.

The patient, who had conceived naturally for the first time after eight years of marriage, was ecstatic to start her journey towards motherhood. However, during her initial scan, a huge intramural fibroid on  the uterus was identified, with apprehension regarding the progress of the pregnancy and eventual delivery method.

In spite of the diagnosis, all scans including nuchal translucency (NT) scan, double marker, and anomaly scan were normal. At 12 weeks, she had a low pulsatility index (PI) of bilateral uterine arteries, for which low-dose aspirin (75 mg) was started to improve placental blood supply and foetal growth.

During the course of pregnancy, the mother had intermittent bursts of severe backache due to the enlarging fibroid. These were treated conservatively with 650 mg of Paracetamol twice daily. Aspirin was discontinued at 32 weeks according to obstetric practice. By 36 weeks, a growth scan had confirmed the fibroid’s severe obstruction of the birth canal, and vaginal delivery was considered impossible. With the malpresentation and the central position of the fibroid on the anterior wall, an elective LSCS was planned, with full appreciation of the likely surgical challenges.

Dr. Kekin Gala, Consultant Obstetrics and Gynecology, at Narayana Health SRCC Children’s Hospital Mumbai , clarified, “This was a very difficult case because of the location of the fibroid. It was in the very area where classical and lower segment incisions are usually made, making it a dilemma. We had to plan a modified incision pathway to deliver the baby safely.”

During intraoperative management, the surgeons identified a minor spot below the fibroid and cautiously made the cut in that space. After a successful delivery, the team made a deliberate choice to delay myomectomy to another time, to avoid causing intraoperative morbidity. The patient had an uneventful recovery and was discharged within 72 hours.

The family and patient expressed their appreciation: “We waited eight years to experience this beautiful moment, so we were initially apprehensive when we heard of the fibroid and the possible complications. But the Narayana Health SRCC team tackled the issue with so much calm and confidence that we were reassured. Their professionalism gave us the biggest blessing —a healthy baby.”

Dr. Zubin Pereira, Facility Director at Narayana Health SRCC Children’s Hospital, “Pregnancy fibroids are known to complicate gestation and delivery and create malpresentation, pain, obstructed labour, as well as heightened surgical risks. A well-coordinated effort and preoperative planning by our hospital medical team, were crucial in the prevention of a bad outcome. With this case, Narayana Health SRCC Children’s Hospital, Mumbai, once again shone through as an example of exceptional competency in high-risk obstetric care.”

About Narayana Health SRCC Children’s Hospital, Mumbai

Narayana Health SRCC Children’s Hospital, Mumbai, is a 207-bed premier paediatric healthcare institution providing unmatched, comprehensive, world-class care for infants, children and adolescents. Paediatric super-specialties offered at the Hospital include Critical Care & Emergency Services, Cardiology, Cardiac surgery, Orthopaedics and Spine Surgery, Paediatric Surgery, Bone Marrow Transplant, Ophthalmology, Dermatology, Neurosurgery, Neurology, ENT, Neonatology, Neonatal Surgery, Gastroenterology & Hepatology, Clinical Haematology & Haemato Oncology, Cranio-Maxillo Facial Surgery, Thoracic & Vascular Surgery, Paediatric Medicine, Endocrinology, Nephrology, Medical Genetics, Psychiatry, Psychology, Developmental Paediatrics, Rheumatology, Plastic Surgery, Onco Surgery, and Pulmonology. Equipped with advanced technology, it ensures affordable, high-quality medical care, addressing primary, emergency, and complex healthcare needs under one roof.

https://www.narayanahealth.org/hospitals/mumbai/srcc-childrens-hospital