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When to have C-section due to low lying placenta?

(15 Posts)
Abbey123 Wed 06-Aug-08 19:05:25

Hi, mums, I was diagnosed with low lying placenta at my 20, 34 and 36+3 weeks' scans. The doctor I saw said I am very lucky that I haven't had any bleeding yet. I am due to see a consultant tomorrow (37week+3) morning to discuss about the C-section, coz my baby is smallish at the mo (5lbs9), I want to give her more time to grow, but equally I dont want to risk anything. I wonder can anyone who had C-section due to low lying placenta share some experiences and tell me how many weeks were you when you had your section? Many thanks........

kitstwins Thu 07-Aug-08 11:35:02

I had placenta praevia diagnosed at my 20 week scan (I was pregnant with twins). Both placentas were posterior and I was told that although it might move away it was unlikely due the space limitations. Unfortunately, I had big bleeds from 23 weeks onwards, two of which triggered labour (at 25 weeks and 31 weeks) which they thankfully blocked with drugs.

I was unlucky, as some people are, and in the end I was scheduled for a c section at 36 weeks. My consultant wanted to get me to 37 weeks as the babies are much more robust then and would have been considered full term, but I couldn't cope with the bleeds and being in hospital any longer and so he grudgingly agreed to bring it forward by a week. He was very keen to stress that it's a balancing act with placenta praevia - you don't want to bring the babies out too early as then they can require special care related to their tiny size (help with breathing, feeding tubes, etc.), but at the same time you don't want to run the risk of a bleed as this can present complications and the need for an emergency c-section.

In the end, I had a huge bleed at just over 35 weeks and had an emergency c section. However, as I'd had steroids at both my labour scares (25 and 31 weeks) the babies were fine and didn't need special care or help with breathing. The only issue was that because they were born before 36 weeks they didn't have much of a suck reflex (this isn't developed until around 36 weeks gestation) and so they were tube fed for a few days and were slow to feed for the first month. But we got there and, although I split fed with formula and EBM I also managed to breast feed as well and they are now very healthy 22 month olds.

I think you've done fantastically to get to 37 weeks and the fact that you've had no bleeding to date is very reassuring. So alhtough the baby isn't huge, it is still a good size and at 38 weeks would be considered full term.

Hope this helps and good luck.

PrimulaVeris Thu 07-Aug-08 11:53:21

I had one at 42 weeks, no bleeding either. (They did scan 2 days before I was to be induced and discovered it - thank god). I had to have a general anaesthetic as placenta was totally anterior.

I was very, very lucky. To be honest if it had happened again, my advice would be to go with consultant's advice and have C-section at 38 as you don't want to risk bleeding and complications and dont want to end up with an emergency section.

Ellbell Thu 07-Aug-08 12:02:56

I had dd1 at 36 weeks due to placenta praevia. She was 4lb 12oz and had some feeding problems (was tube-fed for nearly 2 weeks) but otherwise was absolutely fine (no breathing problems, was not in SCBU). I had been in hospital with recurrent on/off bleeding since 27 weeks, though, so was lucky to get that far. Like kitstwins I'd had steroids for her lungs, but they stopped them at about 35 weeks because the lungs are developed by then (they thought I was goign to have to have her at 27 weeks). You wouldn't need steroids now. If I were you, I'd be wanting to have that baby asap. Bear in mind that an elective section now will be much better (calm, done under local anaesthetic, your dp will be able to be there, etc.) than an emergency section done if you go into labour, which could be life threatening, might well need to be done under general anaesthetic, might happen when you're on your own etc.

Sorry to sound alarmist, but honestly your baby will be fine now (and growth scans are notoriously inaccurate, so you might be surprised by the size anyway).

southeastastra Thu 07-Aug-08 12:04:51

had mine at 38 weeks, bled on and off too and was in hospital from about 36 weeks.

Son was 5 and a half pounds but put on weight very quickly! try not to worry too much

BlueDragonfly Thu 07-Aug-08 12:07:01

it differes from hospital to hospital. I was told that for anterior placenta praevia, if i had no bleedsor other problems then i would have a section at 37 weeks, under general because of placenta position

Abbey123 Thu 07-Aug-08 13:43:15

Thanks, guys, I too don't want to have emergency C-section. I went to see the consultant today at Royal London (my NHS), coz the scan result wasn't clear (just said <5mm), they wanted me to do another one there and then, but I waited for 2 hours, still no sonographer, eventually, they booked me in for next Wednesday for the scan and see the consultant on Thursday (I would be 38+3), when I questioned about the timing, the consultant said he would do the C-section for me around 39 weeks anyway, so I can wait........if anything happens during this week, I will just have to go to the labour ward and they will do the emergency one for me!!!shock I was really not happy, but seeing a private consultant tomorrow lunch time, hope he can be a bit more helpful.........will keep you posted

Highlander Thu 07-Aug-08 13:55:00

I had mine planned at 39+2. I had bleeding on and off from 26 weeks. I had an amnio at 17wks and the consultant said I was low and anterior and to make sure they had a good look at the 20wk scan.

Unfortunately midwives do the scans at my hospital and, despite bleeding (HELLO!!!!!!) from 26 weeks they missed a mild previa on 2 further scans.

DS2 was predicted to be small, but was smaller than they thought. Because the surgeon wasn't expecting the placenta to be so low, he nicked it and there was a bit of bleeding. The placenta had also started to fail.

Afterwards, he said if I had gone for a VBAC (ie gestated beyond 39 weeks), there would have been a significant chance that DS2 would have died in utero. went undiagnosed.

Sorry Abbey, I'm not adding anything useful to your thread. I'm sooo bitter about the whole midwife thing I still feel angry

Abbey123 Thu 07-Aug-08 15:24:01

Gosh, Highlander, sounds like the c-section saved your son's life! I would be very angry as well, these big hospitals are so messed up and I had to fight really hard to get to see the consultant today, yet, I was fobed off again. Having read the threads, I dont really want to wait that long, as any point after 37weeks are considered to be full term.

SazzlesA Thu 07-Aug-08 15:31:52

Message withdrawn

Mikafan Thu 07-Aug-08 15:37:01

Mine was at 37 weeks again because of bleeds and high blood pressure

amijee Thu 07-Aug-08 21:00:01

hi abbey

I don't want to scare you but i would just like to share my recent experience with you.

I was told I had a low placenta at the 20 week scan and was due to be re scanned at 36 weeks. I thought nothing of it and even considered a home birth.

I had a small bleed at 34 weeks and was dmitted overnight and was told my placenta was still low but they would re scan at 36 weeks as planned. They did not do a transvaginal scan ( as they should have done)

At 35 weeks, I had a massive bleed ( at work) which ended in an emergency section. Thankfully, we were both ok and went home after 2 days as my dd did so well.

I found the whole experience extremely traumatic and felt I had not been gvne the correct info during my 1st admission. I think it's important you get a transvaginal scan done for accurate localisation. Also, if you google the RCOG info on placenta praevia it is very good.

I wish you all the best and hope you come to the right decision for you.

Ellbell Thu 07-Aug-08 23:08:50

Abbey... I don't want to scare you either and it probably depends on where exactly your placenta is (have they given you a 'grade' of placenta praevia?) but I think that they are being a bit blasé about just letting you risk going into labour. I know that my case was quite extreme (I was told that my placenta was 'hanging by a thread'!) but I was not allowed to go home from hospital, despite living only 5 mins drive away, because they said that if my placenta detached my baby would need to be born within 10 minutes (hence the general anaesthetic; no time to do an epidural) to save both my life and hers.

Having said that "<5mm" sounds as if the placenta is maybe near the os but not covering it, so it may well not be as serious as all that.

I hope you get some sense from the consultant you see tomorrow, anyway.

Abbey123 Fri 08-Aug-08 21:32:00

Thanks Amijee and Ellbell, the meeting with the consultant went well, I will be admitted to the Queen Charlottes on Monday evening to have the C-section on Wednesday. I only got this slot coz the lady who had my slot just had an emergency one today! And the consultant came directly from the operation threatre to see me. But....this Wednesday is 13th, would like it to be Friday 15th. The consultant will let me know if there is any slots came available on Friday during the weekends, though he told me his birthday is 13th as well.......wink. That kind of made me a bit confortable about the date coz He is a renowned surgeon. hmm

Ellbell Sat 09-Aug-08 17:14:34

You'll be fine, Abbey. At least it's not Friday 13th!

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