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I have placenta Previa major and am getting really anxious.....

(13 Posts)
Thinkingpositively Mon 27-May-13 00:32:15

My placenta is covering O.S and is both posterior and anterior. The midwife said it was a dead cert it won't move and I will need to have a c-section under general anesthetic. I was also told to expect to be admitted to hospital at 33 weeks and might possibly need a hysterectomy as it could become embedded in my uterus.

I did come to terms with this after really grieving that I wouldn't be able to give birth vaginally.

I am really worried, the plans I had to finish work, prepare for ds to arrive and nest all feel like they have gone out of the window. I am struggling to be bothered with deadlines and feel unfocused on both my work and my pregnancy. I am not depressed. Just worried and a bit dazed really. I am 27 weeks next week and have my next scan at 32 weeks which feels like D-Day.

A midwife friend says that i have basically been treated appallingly and scaremongered and the placenta could move and not develop into accrea. She said this before i inquired as to exactly where it was? The sonographer also said that it could move. I really want to know exactly what is going to happen.....

amazingmumof6 Mon 27-May-13 04:26:03

oh dear, why are they scaring you like that? that is out of order!

I mean it's all well to tell you the worst case scenario, but there's no way they can say what will happen in the next 6 weeks!

I'm not surprised you can not focus on anything, but please, please try and think positively!

Until you had that scan nothing is sure!

I had placenta previa with DS1 and had last scan at 34 weeks, which showed everything was ok. (she was VBAC)

not sure about your situation compared to mine, and yes, you might end up with a C-section, but is it necessary to have one so early? can you wait and re-scan at 35 or even 36 weeks?

I also had a problem during my last pg - it looked like that C-section scar may have fused with part of the uterus, but at late scan it was all good as well.

can you get a second or third opinion? even a private consultation?

I honestly don't think that "all is lost", you need more time and more information.

And I'm sending you a big hug! x

mayhew Mon 27-May-13 08:27:37

If the placenta is covering the os completely, it is unlikely to move out of the way as the uterus grows in late pregnancy. However, it is likely that you will have another scan to check because sometimes a single scan can have a misleading result.ie false alarm

Nowadays its is rare for women to be admitted to hospital in pregnancy for this reason unless there has already been some bleeding.This might be influenced by how far away from medical help you are. If you do bleed, call 999 and get an ambulance even if you think its only a little bit, its much safer.

You need to meet with a consultant asap to make a plan about when to present to hospital (usually at the slightest sign of bleeding) and the safest time to deliver.Normally the aim is to get the baby to maturity but avoid the cervix dilating, which can loosen the placenta. This is often around 37 weeks. I have seen it done under spinal/epidural but the woamen were aware that if the surgery turned out to be more complicated than expected, then a change to GA would be needed. It is safe to start with spinal and move on to GA.

Accreta can occur, it is rare but more often seen in women who have had a previous cs. There's nothing you can do about this, it will be dealt with at delivery.

The most senior obstetrician available would do your op, normally the consultant. Everything will be planned for maximum safety.

amazingmumof6 Mon 27-May-13 13:04:46

mayhew do you think hysterectomy is a very likely complication? it seems strange to me that she's been told it's a done deal, almost.

mikkii Mon 27-May-13 13:45:58

Please don't panic. I had placenta praevia with both DC 2 and 3. Having known 3 other people with PP I expected to go to 38 weeks and have a planned CS. That didn't happen. Both times my placenta fully covered the cervix and did not move at all. I was classed as grade 4, which is as bad as it can be. I have been told that PP can be either stable or unstable (a bleeder) I am the latter.

At 33.5 weeks with DD1 I had a substantial haemorrhage and was admitted for observation. Released after 48 hours, I was back in within 24 hours. I had her in a scheduled CS at 37.5 weeks, refusing to have her at 38 weeks as it was my birthday. I had a spinal not general anaesthetic.

With DD2, I was first admitted with bleeding at 24 weeks, then 26, three times within a week at 31 weeks then in 33 weeks until the birth. I had a CS booked for 37 weeks, but a week before that I started to bleed, turned out to be the start of an abruption, after about 30 hours of bleeding and continual monitoring, when told I was still booked for the following week I asked if they were waiting for me to have even more of a crisis? I had an emergency consent form within 10 minutes. The consultant scanned me at my bedside so he knew what he would be dealing with. In this pregnancy my placenta stretched from behind the cervix up to where big maternity pants come to. I was told it was the biggest he had ever come across!

I still had a spinal not a general.

Have they said why you need to be admitted? I was due to bleeding, no-one else I know was admitted.

You can only get placenta acreta if you have previously had surgery on your uterus as it is the placenta growing into the scar. You do not mention previous surgery, but if they are concerned I had an MRI to look at this.

Please feel free to PM me.

Thinkingpositively Mon 27-May-13 14:47:17

Thanks everyone. This is my first baby so I haven't had any previous scarring. mayhew i know the drill!! Thank you though. My dh colleague who was given exactly the same prognosis, also baby number 1, has just had an emergency c section a week after being admitted following a bleed.
i am just trying to go with the flow and enjoy the pregnancy. I think that having never heard of the condition before i was very shocked and worried. Now having heard various stories with good outcomes I am reassured. amazingmumof6 crikey,that is impressive! thank you. My placenta is mostly at the back with a bit of it, or 'large lip' covering the front. It would be absolutely amazing to be told at the 32 week scan that it's all fine and I can have a vaginal birth.... I'm not holding out for that though...not at all....Baby is getting HUGE, i am eating lots to put weight on him incase he is early. mikki it's great to hear that you didnt have to have a GA.... I bawled watching OBEM the otherday. It really unset me that the new baby was handed to Mum, dressed, washed and cleaned after she recovered from anesthetic. I really would hate that to happen...........

amazingmumof6 Mon 27-May-13 14:57:16

good thinking about eating well, but try to avoid too much sugar as it could make baby too big, IYSWIM.

My DS1 was 9lb 2oz, so having a big-ish baby means it could still be ok.

I'm glad you are getting some great advice here, especially PP!

Thinkingpositively Mon 27-May-13 15:31:25

I am going through erratic eating patterns at the moment. Big bouts of eating entire packets of biscuits and sweets then days of salads and simple meals. I eat fruit, nuts, musili and dairy every day. the bits in between vary! Maybe that is why comparatively my bump is bigger than other peoples?!!

Does having a big baby stretch the uterus and make it more likely that the placenta will move?

mikkii Mon 27-May-13 15:52:16

I wish it did, DD1 was 2.5 weeks early and weighed 8lb 11oz, I was really glad she didn't to to 40 weeks or beyond!

One thing I forgot, they may give steroids to mature the baby's lungs, I had these with both girls and they were fine. DD3 was born at 36+1 and had 10 minutes in a warmer, out within 48 hours of birth.

If I could give you one piece of advice-pack your bag now, you may not need it, but better to be ready.

Following the problems with DD1, I asked at 13 week scan if they could see where the placenta was, the scanner said no, so it's either at the top or bottom. This was confined at 20 week scan. I packed my bag immediately. I was really glad it was ready. With DD1 I swanned into the maternity unit with my notes and a book, was staggered to be told I was being admitted!

The size of your bump can also be affected by the size and placement of the placenta. With DD1 she was transverse until about 35 weeks, as the placenta stopped her turning head down.

Where are you geographically? I had all mine at West Midd.

Thinkingpositively Mon 27-May-13 15:59:21

Thanks that makes total sense. That is why little man is positioning himself awkwardly!! And why my bump is very high up....

I am going to take you advice mikkii and pack a bag tonight. It will hopefully be sitting in the hall for another couple of months but having it ready with favorite underwear and P.J's will be reassuring. Thank you so much.

I am in East Midlands.

mikkii Mon 27-May-13 21:41:04

When I had dd1 I was given no advice by the hospital at all, with DD2 I was given a leaflet which was quite useful, has the hospital given you anything?

I have looked online but unfortunately the leaflet is not available.

Other advice I have remembered - no sex and no flying.

Thinkingpositively Mon 27-May-13 22:21:49

yes, i was given a leaflet about it. Very little advice though. Just told to carry my notes with me everywhere I go, even round the supermarket. Was also told not to have sex.

I have started packing my bag for hospital.

mikkii Tue 28-May-13 23:14:10

Thinking, I want you to realise that including myself, I know 4 people who have still had PP at the late scan (mine was at 34 weeks each time), I was the only one to have any admissions, the only one who had an emergency CS. Everyone else had a planned CS and went on to have a second normal pregnancy, although at least one had a second CS.

MAYHEW's advice about calling an ambulance follows the advice I was given, which was "if it is any more than one drop of blood, call an ambulance". I didn't ever call one, although in retrospect there were a couple of occasions when I really should have done. (In fact, the last time I was admitted, I had been banned from travelling to a family wedding, I was at home with DM and DD1, I felt the bleed, went and checked, saw it was already passed hospital dinner time, so finished cooking and ate my dinner).

A hysterectomy is always a potential complication from a CS, but when I queried this, I was told that this was a last resort and would only be done to save my life, so please try not to worry about this too much.

My experience has told me that some medical professionals are so jaded by dealing with medical problems on a daily basis that they become blasé about them and misjudge the impact the problems have on the families concerned. I'm sure they didn't mean to scare you, but when these things are thrown at you, you don't think of the questions you should ask, they come later.

Have you managed to arrange a consultant's appointment?

Fingers crossed, you will be like my friends and go straight through to a planned CS, if not, you have your bag ready. With DD1 I was in hospital for 3.5 weeks before having her.

Good luck.

Ps, follow the ambulance advice, not the cooking dinner example!

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