Placenta Previa...board dr/cnm/cpm's?

[mommaduck]

For various issues taking place at the beginning of this pregnancy, I've had half a dozen ultrasounds. Several weeks ago they discovered that the placenta was forming near the cervix. Last week's u/s showed that I have full on previa. Pelvic rest, no lifting, no vigorous activity (not real clear on that one), and I'm guessing I should avoid the stairs as much as possible (not completely possible as I'm in a 3 story row house with the only bath on the 2nd floor and the washer/dryer in the basement...so three flights of stairs, though I can avoid going to the third floor).

 

I'm 14wks, hoping the placenta will move up, but not certain that that is realistic as this is my 11th pregnancy and I'm sure there probably isn't a lot of healthy space in my uterus for it to go (apparently wherever previous placentas have attached there is scarring?). I've never had a c-section, would like to avoid one, but would like to know the reality of my situation as well. Anyone been there or any board ob/cnm/cpm's on here? Anything further I should/shouldn't do?

[MyLittleWonders]

Not an ob/cpm/cnm, but wanted to offer :grouphug: and to say I've been there. It was my first pregnancy, but it did correct itself by about 7 to 7 1/2 months. Up until then I had spotting and sometimes light bleeding throughout. This pregnancy (my 4th), I had spotting for the first 4 months. My MW didn't think it was previa, but in the beginning when we were discussing the possibility, she said that most of the time it will correct itself as the uterus expands (even in subsequent pregnancies). So, hopefully yours will eventually correct.

[wapiti]

I'm no health professional. The only advice I have is that if the placenta does move, later on consider requesting a color doppler ultrasound to rule out vasa previa. (see e.g. www.vasaprevia.com) Good luck with your pregnancy!

[m0mmaBuck]

I had complete placenta previa with DD. She was my 4th pregnancy. Other than pelvic rest (and my understanding was that means no penetration OR orgasms of any sort) and no heavy activity, there wasn't really much I could do but wait and see. I joked that I would stand on my head 23 hrs out of the day if they thought that would move it but the reality is that it's a waiting game.

 

Good luck to you. I hope that the pesky placenta relocates to a more desirable neighborhood.

[Jennifer in MI]

I had a partial previa with my fourth. It ended up moving by my delivery date, but it was still pretty low. I did bleed quite a bit, but my midwife was ready and had the right drugs for me!

 

I pray it moves and moves quickly!

[Pink Fairy]

I was diagnosed with it during my 6th pregnancy. It did move, but I had a lot of bleeding and complications with that pregnancy. I ended up on very strict bedrest, only getting up to use the bathroom.

[mjpeter]

I had a previa with my third pregnancy, diagnosed at 15 weeks after some spotting. It did end up moving by my 24th week or so, and I had no other complications....hoping yours will do the same!

[Heather in OK]

I am a DEM. :)

 

How much it might possibly move up will have a lot to do with how much of it is actually covering the cervix. I have had clients who had placentas very close and almost covering the cervix early in pregnancy. In follow-up ultrasounds the placenta had moved. However, I haven't had a client who was dxd with a complete previa.

 

Was it dxd as a complete previa? According to this study, a complete previa remains so.

 

http://www.ncbi.nlm.nih.gov/pubmed/11978274?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

 

 

Unfortunately the majority of women who have a previa (partial or complete) will be delivered via c/s. And possibly prior to your EDD. Even when the placenta is close to the cervix and not covering it, a c/s needs to be done. As the cervix dilates, the opening becomes closer to the placenta site risking an abruption. There is an illustration here that shows what I'm talking about: http://www.moondragon.org/obgyn/pregnancy/placentaprevia.html

[Laurie4b]

I'm glad you got it diagnosed early.

[mommaduck]

Thanks, ya'll. I'm just really nervous about any potential for c-section. Thank you, Heather, for the links :)

[Amy in KS]

I had a previa that moved up away late (last trimester). I did have spotty bleeding, etc. I did deliver vaginally with that child as well as the subsequent two.

 

My best advice is to find a great obgyn who has experience with an abruption to be on the safe side. I had one recommended to me and I'm glad I did (but for a different reason). My body always wants to bleed out after deliver (not related to previa)...

[GWOB]

For various issues taking place at the beginning of this pregnancy, I've had half a dozen ultrasounds. Several weeks ago they discovered that the placenta was forming near the cervix. Last week's u/s showed that I have full on previa. Pelvic rest, no lifting, no vigorous activity (not real clear on that one), and I'm guessing I should avoid the stairs as much as possible (not completely possible as I'm in a 3 story row house with the only bath on the 2nd floor and the washer/dryer in the basement...so three flights of stairs, though I can avoid going to the third floor).

 

I'm 14wks, hoping the placenta will move up, but not certain that that is realistic as this is my 11th pregnancy and I'm sure there probably isn't a lot of healthy space in my uterus for it to go (apparently wherever previous placentas have attached there is scarring?). I've never had a c-section, would like to avoid one, but would like to know the reality of my situation as well. Anyone been there or any board ob/cnm/cpm's on here? Anything further I should/shouldn't do?

 

With my first, my placenta was very close to my cervix. It moved and I had no complications.

 

Thanks, ya'll. I'm just really nervous about any potential for c-section. Thank you, Heather, for the links :)

 

I've never had a c-section, and I know how scary they seem, but delivering a healthy baby is the ultimate positive outcome. I've had miscarriages before. I would have gladly delivered those babies with a cut from here to there, even though I am a huge proponeent of natural childbirth. Please rest, grow that beautiful gift, and don't worry about how your meet him/her. :grouphug: It is scary. I know. We will keep you in our thoughts and prayers.

[mommaduck]

I've never had a c-section, and I know how scary they seem, but delivering a healthy baby is the ultimate positive outcome. I've had miscarriages before. I would have gladly delivered those babies with a cut from here to there, even though I am a huge proponeent of natural childbirth. Please rest, grow that beautiful gift, and don't worry about how your meet him/her. :grouphug: It is scary. I know. We will keep you in our thoughts and prayers.

I've lost three; I think I'm quite aware of that and I'm not scared of c-sections because of an over-emphasis of natural birth. Not sure why anyone would think that I would consider that above the health and safety of my baby. I'm scared of them for other reasons and one being the fear that something would go wrong with the baby either way. But thanks for the prayers.

[HS Mom in NC]

I'm not sure you're far enough along to accurately diagnose it at this point. Placenta previa means the placenta is attached to the cervix.

 

The uterus is like a balloon. If you draw a circle (to represent a placenta) near the part where you blow into it on the balloon while it is deflated or mostly deflated (like a uterus in early pregnancy) it can appear to move as you inflate it (or as your uterus expands over 9 months) but the circle has never actually changed from its original location. Your placenta is attached by blood vessels and will not be moving from its original location until it detaches after delivery. It too will expand over time, so they'll have to see it it expands over the cervix. I think it will only be accurately diagnosable much later in pregnancy.

 

Be sure whenever an OB or midwife claims you have to have bedrest or a c-section you demand they produce the studies and go over them with you. (There's an entire book written for medical professionals called Obstetrical Myth vs. Research Reality dedicated to the subject of standard medical advice not matching actual medical research.)

 

All c-sections have risks, so the important thing it to determine if the c-section is risker or if a natural delivery with a particular complication is riskier, then choosing the option with the lowest risk. Either way, these days riskier pregnancies are much more manageable than they have ever been and the likelihood of a baby not having a good outcome is extremely low.

 

An example I experienced in a different situation than the one you're having:

 

I was told standard bed rest for 6 months because of a placental abruption was necessary by my midwife and back up OB. I told the midwife I would get in bed, but she and the back up OB had better produce real evidence to prove it was necessary-it took six weeks for them locate the studies and it turned out the studies actually showed no difference in outcomes among women confined to bed and those that did not stay in bed. There was still risk of complications, but staying in bed did not reduce them at all. It appears bedrest in that situation is just psychotherapy and not based on real science.

Edited October 26, 2010 by Homeschool Mom in AZ
adding a thought

[mommaduck]

I'm not sure you're far enough along to accurately diagnose it at this point. Placenta previa means the placenta is attached to the cervix.

 

The uterus is like a balloon. If you draw a circle (to represent a placenta) near the part where you blow into it on the balloon while it is deflated or mostly deflated (like a uterus in early pregnancy) it can appear to move as you inflate it (or as your uterus expands over 9 months) but the circle has never actually changed from its original location. Your placenta is attached by blood vessels and will not be moving from its original location until it detaches after delivery. It too will expand over time, so they'll have to see it it expands over the cervix. I think it will only be accurately diagnosable much later in pregnancy.

 

Be sure whenever an OB or midwife claims you have to have bedrest or a c-section you demand they produce the studies and go over them with you. (There's an entire book written for medical professionals called Obstetrical Myth vs. Research Reality dedicated to the subject of standard medical advice not matching actual medical research.)

 

All c-sections have risks, so the important thing it to determine if the c-section is risker or if a natural delivery with a particular complication is riskier, then choosing the option with the lowest risk. Either way, these days riskier pregnancies are much more manageable than they have ever been and the likelihood of a baby not having a good outcome is extremely low.

 

An example I experienced in a different situation than the one you're having:

 

I was told standard bed rest for 6 months because of a placental abruption was necessary by my midwife and back up OB. I told the midwife I would get in bed, but she and the back up OB had better produce real evidence to prove it was necessary-it took six weeks for them locate the studies and it turned out the studies actually showed no difference in outcomes among women confined to bed and those that did not stay in bed. There was still risk of complications, but staying in bed did not reduce them at all. It appears bedrest in that situation is just psychotherapy and not based on real science.

Good points. Right now it's still forming. The concern is that it's forming over the cervix. Granted, this doesn't mean that it's attached there or yet. I saw the u/s, most of it is not on the cervix, but one end of it is. I think that is the concern, that it may try to attach there. My personal concern was the probability of it actually doing that, as I've had so many pregnancies. I'm sure it's something they will continue to watch. I'm just praying that it doesn't attach there.

[GWOB]

I've lost three; I think I'm quite aware of that and I'm not scared of c-sections because of an over-emphasis of natural birth. Not sure why anyone would think that I would consider that above the health and safety of my baby. I'm scared of them for other reasons and one being the fear that something would go wrong with the baby either way. But thanks for the prayers.

 

I think I came across as crass, and for that I am truly, deeply sorry. :grouphug: I do know people who have safely delivered healthy babies via c-section who had placenta previa. I also know that it is hard to stop worrying about a pregnancy after miscarriages, so I will just shut my big fat mouth (after I remove my foot) and continue to pray for healthy babies and peace of mind.:grouphug:

[mommaduck]

I think I came across as crass, and for that I am truly, deeply sorry. :grouphug: I do know people who have safely delivered healthy babies via c-section who had placenta previa. I also know that it is hard to stop worrying about a pregnancy after miscarriages, so I will just shut my big fat mouth (after I remove my foot) and continue to pray for healthy babies and peace of mind.:grouphug:

I was a bit overly sensitive...I'm sorry. We all have those days (a lot for me lately). Blaming the hormones on this one (((hugs))) thank you for the prayers :)

[mama2cntrykids]

(((Hugs)))-I had placenta previa with my third child. I was dx at about 30 weeks and by the time she was born, it had moved out of the way. We did a lot of praying. I am so glad it moved because I too didn't want a c-section.

 

I hope things turn out right!

[Mommy22alyns]

I had a complete previa with my second DD. It was diagnosed at 20 weeks and monitored by u/s. They thought it had moved and would move enough to allow a vaginal birth, but at 32 weeks, 1 day I had a severe bleed that landed me in the hospital on bedrest until a scheduled C-section at 36 weeks. However, my scenario was a pretty rare one. I think the numbers were somewhere around less than 1% of previas stay complete and cause the complications I had. My advice - even if they "think" it's moving, act like it hasn't! Because they were completely wrong about mine. :grouphug:

[AnotherLinda]

I had a complete previa with my second DD. It was diagnosed at 20 weeks and monitored by u/s. They thought it had moved and would move enough to allow a vaginal birth, but at 32 weeks, 1 day I had a severe bleed that landed me in the hospital on bedrest until a scheduled C-section at 36 weeks. However, my scenario was a pretty rare one. I think the numbers were somewhere around less than 1% of previas stay complete and cause the complications I had. My advice - even if they "think" it's moving, act like it hasn't! Because they were completely wrong about mine. :grouphug:

 

My placenta previa story is exactly the same as yours. Bleeding at 32 weeks and a hospital stay until the c-section at 36 weeks. Today she is a beautiful, brilliant ten year old.

[linders]

I had full previa, discovered at 6 weeks when I bled heavily (I assumed I was having a miscarriage). I ended up with extra monitoring by a specialist throughout the pregnancy and had to limit my activities as you have been advised, but no bed rest (that was a possibility if there were any more severe bleeding episodes). I didn't avoid stairs and still went for a (slower and shorter) walk daily.

 

It never moved so I had a c-section at 37 weeks (after amnio to confirm that DS's lungs were mature). If you still have previa late in the pregnancy a c-section is guaranteed. Labor will cause massive blood loss.

 

That c-section (and the one I had to have subsequently) wasn't bad at all, actually easier to recover from than some other abdominal surgery I ahve had.

 

Best wishes, I have heard the placenta can move.

Edited October 27, 2010 by linders