Placenta Previa

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tink9702's picture
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Placenta Previa

I had my 20 week u/s today and my placenta is completly covering the cervix. My MW's are going to monitor closely and I have another u/s in 4 weeks.

Anyone know stats on how likely it is to move? Also, is there ANYTHING I can do to help it? MW also mentioned that I am not allowed to lift anything (even my son if at all possible), and to really take it easy - why?

At what point (how many weeks) would you be convinced that it was not going to move and give in to a c-section?

I'm not happy about this and thought everyone on this board would understand where I'm coming from!!

thanks for any insight you might have!

MrsMangoBabe's picture
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I'm really sorry to say this, but the chances of a complete previa diagnosed at 20 weeks moving far enough away from the cervix for a safe vaginal delivery do not appear to be good. Here is an abstract from a study about it: http://www.ncbi.nlm.nih.gov/pubmed/11422970?dopt=Abstract I would hold out some hope until your next ultrasound and see what they say. If you have to have a c-section, you can still have a great birth, though.

I believe the no lifting and taking it easy are because there is a higher risk of early placenta separation with a complete previa.

krazykat's picture
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I don't know much about it, but I just wanted to send my well-wishes. (((HUGS))) I really hope everything turns out for the best, and please KUP!

TiggersMommy's picture
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I'm so sorry to hear about your placenta previa. I have no personal advice but there is a woman on my October board who is an excellent resource for all things placenta previa and vasa previa. There is a thread stickied on our board with links to a lot of information. Just a warning, I don't think much of it is really uplifting and it inherently focuses on the medical aspects. So, if you're trying to concentrate on staying positive you might want to pick and choose what you read.

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I'm so sorry to that you have placenta previa. I don't know much about movement of the placenta during pregnancy but I hope everything works out for the best for you. I'd be really unhappy too and would probably want it monitored up until the end JIC.

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Lurker

So at 9 weeks i had a complete placenta previa, lots of on and off again bleeding, was told to be on bed rest etc. At 18 weeks, it was said to still be very low , but no one ever told me how low, follow up around 30 weeks and it was low , but I was told it shouldn't be a problem (found out way later that it was 1.4 cms away). Had another u/s at 37 weeks and found out it was at 1.7cms away from the cervix.

I cried and cried (lost my homebirth) but I did go on to have a vaginal birth at 41+ weeks. I was fortunate that I had an OB that would let me try a vaginal birth. I didn't quite get the birth I wanted but at least I didn't have to have a c section. I did bleed a lot more than with my 1st, and they did try to speed up my labor because of some bleeding in labor, but everything turned out ok. My OB told me that it she wouldn't really be able to tell if I needed a c section until I was in labor, it would just depend on how the baby was positioned, etc. I did make sure I could go as long as possible to help the placenta move as much as possible before I labored. Everything I found said that less than 2 cm was grounds for a c section but sometimes you just have to get a
2nd opinion.

That pregnancy was a roller coaster ride, not really knowing what was going to happen. I started care with a HBMW, then went to an OB, switched OB's, did dual care with my HBMW until 31 weeks, dropped the OB at 31 thinking I was ok to do a HB, then went back to the OB at 37 weeks. Needless to say, I spent a ton of $ (on dual care)and did a ton of worrying. If there ever is next time I will know to ask lots of questions, not just take "it should be fine" for an answer.
HTH!

faeriecurls's picture
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Sorry about your placenta - do you know if your placenta is posterior or anterior? I was dx with marginal previa at my 20 week u/s and have had several follow up u/s since then. It probably will be too early in 4 weeks to see much difference - mine only moved .2cm between 20 and 30 weeks and at 30 weeks I was still facing a c-section. I had an u/s at 34+ weeks and it had moved almost an entire centimeter. I saw the OB who backs up my m/w yesterday (one week later) and it has moved even more - they think I will be cleared for not just a vaginal, but a birth center birth. I still have 1 more u/s scheduled for 38 weeks.

These are the things I did to try to get it to move (although I have no clue if any actually helped) I started going to acupuncture weekly at 26 weeks, began taking tincture of astragalus 3x a day at 30 weeks, began seeing a chiropractor to help realign my hips & pelvis (which were all out of whack) 3x a week at around 32 weeks, and drinking RRL tea every day.

My m/w and I discussed it and they planned on allowing me to get to at least 37-38 weeks before starting to really solidify plans for a c-section, which they would have done at 39 weeks. I was really discouraged at the ultrasound I had at 26 weeks and the one I had at 30 weeks, because it really barely moved. Then I realized there is more uterine growth between 30 & 40 weeks than there is between 20 & 30 weeks.

The other thing I did at my u/s at 26 weeks and the one I had yesterday was have them do a Transvaginal Color Doppler to make sure that all of the vessels are attached in the center of the placenta and not at the edge. You are at a much higher risk of Vasa Previa with a dx of placenta previa.

I hope your placenta moves for you!

faeriecurls's picture
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Two things I forgot to mention - find out what distance your CP and hospital/bc will allow a for vaginal birth - it does vary between providers - I think on average they say at least 2, but it apparently is not a written in stone "standard". My m/w said around 2 for a vaginal birth but I would need continuous fetal monitoring and a heplock.

The other thing I would recommend (especially as you get later in your pregnancy) is make sure they measure it a few times at each ultrasound - according to the doctor who did my u/s yesterday, the measurements are not so accurate and he took 3 or 4 yesterday and there was a range from 2.4cm to around 3.1cm.

I would also not "give in" to a c-section - even if I had to schedule one, I told my m/w that I would want another u/s before they did anything.

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You need to go to the Oct 2010 board and read the sticky post at the top by 'Uropachild' Sarah. She had Vasa Previa.... sort of same thing right? She has all the facts!

This is serious.

xx

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*Lurker* I also had Vasa Previa so I thought I'd chime in... vasa previa and placenta previa are not the same thing. However, having placenta previa does put you at a higher risk for vasa previa like Erica said. Thats the reason for the transvaginal color doppler. Theres tons of info at www.vasaprevia.org about it for those of you interested.

I hope your placenta moves and you get the birth you want!

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Don't mind anyone who says they had previa in their first trimester, the uterus is still too small at that point for previa to be an issue. For a complete previa at 20 weeks, the odds aren't very good, but they tend to be better if the placenta is more on the anterior, because the uterus tends to grow more that way, but those are just generalities and not your body. I used to think there's nothing you can do, it moves or it doesn't, but I've now heard enough alternate-medicine mamas who have had success with some or all of the measures that Faeriecurls mentioned that I think I'm beginning to be swayed. You want to increase the flow of blood and chi (energy) to your pelvic region, and you want all of your hot/cold yin/yang kinds of things to be in balance, and there are ways to help with that. Definitely give those things a try, and if it moves get the color Doppler to rule out vasa previa, and if it doesn't then you know you gave it a try. If you're still complete previa at term, they will likely do an amnio at 36 weeks and schedule a c-section at 37 weeks if baby's lungs are mature. You simply don't wait with complete previa, because a single contraction that dilates the cervix can lead to placental abruption. For marginal previa, meaning the placenta is still on the cervix but not *over* it, if you've had any bleeding they'll follow the above procedures, but if not then they'll probably monitor you closely & schedule a c-section for 39 weeks. Good luck to you!!!

faeriecurls's picture
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The only issue with an anterior placenta that doesn't move enough for a vaginal birth is that it makes for a much bloodier and more difficult c-section.

tink9702's picture
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Thanks for the well wishes everyone. I'm going to look into the alternative medicine ideas (accupuncture, chi & chiropractic).

My placenta is anterior which sounds good and bad. I will ask about the vasa previa at the next appointment and have them do the color doppler to make sure. I also will inquire as to what the plan will be regarding scheduling etc. I did ask at the appointment how far along the MW had seen something like this situation where the placenta did move fully up and she said she's seen one woman who had a full previa at 20 weeks that cleared completely by 28 weeks. So I do have some hope.

I'm beginning to be more worried about the placental abruption, hemorhaging (sp?) and the baby not developing fully than the c-section at this point. Of course the earlier a c-section is needed the more worried about the baby's development & lungs I will be. I'm really hanging onto hope that it at least become a partial previa instead of the complete previa so a c-section can be scheduled later rather than earlier.... *sigh* There are way too many things to worry about right now and so many variables! Thanks for listening to me vent.

I'm going to get out my Hypnobabies "Fear Releasing" CD. I think I need it!