Placenta low lying but not covering internal OS So not a problem Still 4 months to go so fair chances would go still further up nothing to worry about Now fibroid part. Ya it may hamper you to have normal delivery still can take a chance

There are some concerns in your scan which might or might not cause any events in the rest of your pregnancy. Low lying placenta most often migrates to the upper segment as the pregnancy progresses. If it doesn't, it might cause episodes of bleeding as the pregnancy progresses, usually each episode more severe than previous one. So focus on taking iron supplements regularly to ensure you aren't anemic, avoid constipation, sexual intercourse, vigorous couging. Coming to fibroids, they usually grow bigger in pregnancy because of the hormone changes, might undergo a change in pregnancy, called red degeneration which may cause episodes of pain. They might (especially the left lower anterolateral fibroid) might come in the way of normal labour and delivery. However, all said and done, there is a good chance that your pregnancy might progress smoothly also. Do a bit of research, choose the doctor and place where you want to deliver so that your doctor knows all the concerns in this pregnancy and that you need not panic at a time of emergency, especially in the setting of COVID 19. I wish you all the very best.

LOW LINE PLACENTA AT 20 WEEKS: It will migrate up by 28 to 30 weeks as uterus enlarges with baby growth.  But meanwhile u should take rest and avoid exercise, heavy weight lifting,  Coital activity, Constipation, Cough else you will start bleeding. MULTIPLE FIBROUDS UTERUS: you have not mentioned type of fibroid. Subserosal, Intramural, Submucosal? Generally fibroid interfere with Uterine muscles may lead to Preterm contractions sometimes. And it will interfere with Normal Vaginal Delivery. In view of future pregnancy: I wud suggest to concentrate on current pregnancy and give birth to healthy baby.

Pregnancy with low lying placenta with three fibroid uterus is require special care under Obst & Gynaecologist. Low laying placenta sometimes give rise to bleeding per vsginum so you should take optimum precaution suggested by your Gynaecologist. Fibroid uterus may not allow normal delivery. So don't worry but take special care through  out pregnancy under Gynaecologist.