Placenta failure post 35 weeks?

[sillysow]

Hi there, just wondering if anyone had any knowledge of this, and the detection of it? My consultant last week told me that there was no real way of them knowing - is this really the case?

[frakyouveryverymuch]

I think it can't be detected pre-emptively but that's part of the reason why you should monitor foetal movements and get any changes checked out. A slower rate of growth can also be a sign of a failing placenta.

Are you at risk of it? As in have you had problems in a previous pregnancy or a medical condition such as GD or severe high blood pressure which makes it likely?

[sillysow]

Thank you for your reply frakyouveryverymuch I had GD in my last pg and this one since 12 weeks. So far all has been not too bad - ie diet control and good growth. Its just the decisions surrounding induction that are making me ask the questions - I honestly thought it could be detected.
So movement - or reduction of would be a key indicator?

[frakyouveryverymuch]

Well I don't see how they'd detect it short of continuous monitoring, but I'm not a medic (I just have the same fascination with 'why' as a toddler!) so there might be ways. Even on continuous monitoring it would be as a function of foetal heart rate etc.

Reduction of movement is supposed to be the most reliable indicator, short of continuous monitoring. It can indicate that the foetus is getting fewer nutrients and less oxygen i.e. the placenta is no longer working effectively enough.

Placental abruption is easier to detect but less identifiable in terms of risk factors - hard abdomen and bleeding are classic signs, but the abruption may form its own clot so any hardness accompanied by abdominal pain should be checked.

[frakyouveryverymuch]

Google gives me this article on using a Doppler (but it's dated 25 years ago) however again that would be a case of continuous monitoring, or at least going in for regular assessment, and if everything else is okay so far it probably isn't indicated in your case or your consultant would have mentioned it. Or the article's conclusions have been disproven.

[IngridFletcher]

The hospital can use a Doppler to measure blood flow through placenta and cord. This would be done after the usual period for induction usually though Which would be 40 + 10 at least. 35 weeks is very very early to be be thinking in terms of placental problems unless there is something else causing problems.

[peanutbutterontoast]

I'm at greater risk of placental failure (this baby will be delivered at 37 weeks) - my first was born at 35 weeks when luckily I had a PROM & my placenta was found to be full of clots & heavily calcified, dd was in poor condition.

In later pregnancies I've been treated with anticoagulants and throughout the third trimester I have growth & well-being scans (every two weeks), placental doppler studies done (looks at blood flow/resistance through the placenta), and after 34 weeks CTGs done twice a week. It doesn't eliminate the risk but you can get a decent idea of how the placenta is doing from blood flow, fluid levels, and fetal growth.

I am also absolutely religious about kick counts - 3x a day time it takes to get 10 kicks (usually 15-25 minutes) if it is longer than 2 hours I go into DAU immediately. Any sustained change in the pattern of movements e.g. over 2 days it starts taking 45-60 minutes to get the 10 kicks I go into DAU. My consultant says 'a healthy baby moves' and change in movements is the first sign that something may be wrong.

[peanutbutterontoast]

Oh & I have my first placental doppler at 24 weeks usually - then 28/32/36

[sillysow]

Thank you all - I will have a deeper read of all your fab replies when I get back from work.

My consultant said that doppler use post 35 weeks is not accurate. Hence my concern if there is no way to detect it

[serendipity16]

I also have a doppler scan at 24wks, they checking for notching & check the blood flow.

I've had 2 abruptions, the first was a concealed abruption at 35wks which resulted in my daughter being stillborn. There were no signs at all, no pain, hard stomach, nothing.

With my next pregnany i had the scan which showed everything was fine. At 37wks i was induced due to the previous abruption & stillbirth & due to there being an increased risk of placental failure the closer i got to 40wks.
Whilst being induced i had another abruption, this time though i hemorrhaged..... thankfully as this was a sign i didn't get before & helped save my daughters life.

I've since had 3 more babies but they were all born at 34wks via planned c-section due to me having a high risk of a 3rd abruption.

Whilst the scans are a little comforting, they can't and don't always pick up on something that may happen weeks later. I was having scans at 24,28,32 & 34wks with my 2nd abruption & nothing was ever picked up.

I am given folic acid 5mg to take during pregnancy as they say there is some evidence that the higher dose will lower my chances of having another abruption.