Placenta praevia - any top tips for managing the limbo period till my December scan?

[Ktay]

I'm sure if I do some digging there will probably be old threads on this already but most of them seem to be from people in their last trimester. I had PP diagnosed at my anomaly scan last week (it was already suspected at the dating scan) and, having ignored the dr's advice not to read scare stories on the internet, have managed to worry myself silly by googling.

I have to go back at 32 weeks to see whether the placenta has shifted up. Currently it's completely covering the 'os' but is slightly to the right, so they say if my womb stretches in that direction then there's a chance it will move. (Sonographer reckoned 50/50; dr was more evasive). They haven't graded it yet, is that because it's too soon?

They didn't give me much advice other than to avoid sex, up the iron intake (avoid dairy when eating iron-rich foods and if eating steak, to have it with an orange sauce . Suspect dr might not be a big meat-eater herself...), and call 999 at first sign of bleeding. They also gave me a leaflet to take away. It is reasonably informative but doesn't answer some of the main questions I have now, like do I need to wear a maternity pad and carry a change of clothes with me at all times (or will the bleeding be so bad it renders a maternity pad pointless?)? If the PP is still there at 32 weeks, will I have to start maternity leave straight away? (I think they like you stay close to hospital with a constant companion? If so, should probably warn my boss...) If the placenta does move out of the way, is it likely to move out of the way enough to allow me a completely normal birth or will they want to monitor/induce me? (Had a relatively straightforward birth with DD but don't want to find myself in some intervention-heavy middle-ground this time round if it can be avoided. Although obviously an ELCS because of PP is no picnic either.)

I plan to ask my GP about lots of these things at my 24 week appointment but if anyone can put my mind at rest (or help me face up to the situation) now it would save me lots of anxiety. The hospital were quite blase, which might be a good sign but I'd prefer to be armed with the facts!

[Ktay]

bumping in case anyone spots this over lunch...

[cravingcake]

Probably not a lot of help but dont want to read and run...

I have a low placenta which needs to be re-scanned at 34 weeks but I had a bonding scan (had to pay for it) at 26 weeks which showed it looks like it is moving on up, so perhaps this might be an option for you to help put your mind at ease while waiting til your 32 week scan? I was told at 19 weeks that it will either move, or it wont and there's nothing you can do to help it so try not to worry as you have no control over that.

I personally would say if you wear dark underwear to wear a pad or liner as that will show straight away if you have any bleeding.

Sorry I cant answer your other questions but hope this helps a little bit.

[glitternanny]

I have a low lying placenta too and wasn't told ANYTHING I called my mw the next day to check what I should/shouldn't do and again told nothing!! My next mw appointment they didn't even look at Tge report or acknowledge it in my notes?!

Only 3 more weeks to wait for the scan I'm booked in for at 34 weeks.

Hope someone will be along soon with some advice.

[Ktay]

Thanks both. Maybe I'm worrying unnecessarily about some things? The fact that you have both made it so far along presumably without any significant bleeding is encouraging, I thought I should maybe be on tenterhooks from 24 weeks onwards?!

Good luck for your 34 week scans, I hope your pregnancies prove uneventful and cravingcake that your placenta keeps heading in the right direction!

[cravingcake]

I think its only natural to worry, some of your questions are very valid. I wouldnt know how much bleeding there could be but was told that if I had any, no matter how small to phone MW or labour ward. I've had one tiny amount of spotting (and I mean tiny) a couple of weeks ago and I called them, they arranged for me to go in just to have a check and all is ok. I was told this could be the placenta moving which caused the blood but for me is nothing to worry about, unless I have more (which I havent) or start having signs of labor (currently 33 weeks). I only have low lying placenta, not fully covering so I do hope someone who has been in the same situation as you can help answer your questions better.

It is a long wait from the 19 week scan and if no-one can answer your questions on here then I would just phone MW and ask them, they will be happy to answer your questions and reassure you over the phone.

Good luck

[Ktay]

Thanks cravingcake, not long now then till you find out. Let us know how you get on. Bumping as well in case anyone has had similar situation to mine...

[Stormwater]

I had exactly the same, with no advice whatsoever, just told it had a 50/50 chance of moving upwards. The scan at 28 weeks showed no movement so told to expect a c-section at 38 weeks (still no advice given re what to do if any problems - I learnt a lot on here!). I had another scan at 36 weeks where I fully expected them to say there was no change and I was going to have the cs booked, only to find it had moved enough for them to be happy for me to have a home birth, which happened beautifully at 40+4. So good news from me, hope yours turns out as positively as that.

[Ktay]

Ooh that bodes very well stormwater, fingers crossed!

[SinicalSal]

I've had that twice, and both times was rescanned at 34 wks to show that it had moved.
My first pg I woke up bleeding and was hospitalised overnight - if you do bleed due to it it's totally painless, so you'll need to be alert ifkyim.
I was also advised to not to travel far from a hospital, and certainly not by air.

[Ktay]

More good news, thanks sinicalsal

[aethelfleda]

Hiya- I have a low placenta too (down to the cervix but only on the edge of it) and am waiting for a repeat scan at 32 weeks (early November). They didn't tell me to avoid anything much but I suppose that's because it's not covering the cervix as much as yours.

Of course I went home and trawled the net (you'd think I'd know better!). As I have a sciency background I went straight for the hard stuff and looked up the obstetricians guidelines. There is a good online patient info leaflet on the royal obstetricians college website: i'll post a link shortly.

The gist is this: if you have a complete or partial previa (placenta part or totally over cervix) you need a section. If by 38 weeks the placenta has moved 2cm clear of the cervix you can have a "normal" delivery. If its less than 2cm away they usually recommend a section.

90% of the lowish placentas and 50% of the overlapping-cervix placentas move out of the way- its hard to predict but they move better if a) you've not had a section before and/or b) the placenta is anterior (at the front). If it hasnt moved at 32 weeks they will bring you back for more scans. My friend had this and her placenta finally moved at 38 weeks the day before her planned section and she had a normal delivery!!

If you bleed you may be admitted for bed rest or sent home: if its a bad one they may keep you in from 34 weeks onwards. If you don't bleed they seem more laid back about it. Most of the time it works out fine and mum and baby are Ok (which is the main point).

Hope that helps!

[aethelfleda]

Here's the online guideline I found- it's very matter of fact, but I found it reassuring to read.

www.rcog.org.uk/womens-health/clinical-guidance/low-lying-placenta-after-20-weeks-placenta-praevia

Aethel.

[aethelfleda]

And here's a shorter link in case you're reading this on a phone:

click here for info

[Ktay]

Thanks for taking the time to dig out those links and for your helpful summary. The 50/50 thing is making a bit more sense now. Hope you have some good news at your scan and that it all goes smoothly in the meantime.

[aethelfleda]

Thanks Ktay, I hope your scan brings good news too. If not then we can always atart another pp thread!

[tory79]

Hi Ktay

I too found out I had pp at my 20 week scan. I was basically told NOTHING, not to avoid anything, not to do anything, the sonographer just said I would be booked in for another scan at 32 weeks. Next time I saw the mw she saw it on my notes - the placenta was completely covering, and she said it would be a 'miracle' if I didn't need a section. Her only real advice was to call an ambulance if I was bleeding enough that it was running down my legs!!!! Anyway, it was only after that (at 26 weeks) that I actually went away and looked up pp as up until then to be honest I had no idea there could be any other complications other than needing a section!!

Fast forward to now, I have had 1 teeny bleed, and I do mean teeny, I have had my 32 week scan which showed that not only has it moved, it is now in fact 1.5cm clear, so am now waiting for a 36 week scan next week to see if it has moved any more!

I think pp is much the same as anything - it can affect people in different ways. If I didn't know I had had it, I wouldn't have known I had it )if that makes sense!) I know there are people for whom it has had quite serious effects, but I think the main thing is just to take it a bit easy and watch out for any bleeding. Unless you get any bleeding I would try not to worry about it too much! In terms of a section, what will be will be is my view!

xxx

[Ktay]

Hi Tory, thanks for your post. I'm glad your placenta seems to be defying the odds! I hope you clear that extra 0.5cm in the next week...

Sounds like it can actually all be a lot more straightforward than the scare stories would have you believe, it has been very reassuring to hear everyone's experiences.

[Panzee]

I was told nothing and carried on as normal. Yoga, swimming, even did some mini hurdles during a PE lesson . No problems and I never bled. Had a section at 38 weeks.

[myhandslooksoold]

Hi I was told I had PP at 20 weeks and was given no advice but told to come back at 37 weeks for another scan.
After doing research on the internet we decided to avoid sex for the rest of the pregnancy and to generally take things easy-ish.
Went back at 37 weeks to be told it was still covering OS and baby was also breech so I would need to come straight into hospital to stay for a week and then have C section sometime after 38 weeks. Begged the consultant to let me home as I had a 17 month old DD. I was allowed on the proviso that my DH or someone adult was with me constantly and I wasn't too far from the hospital so could be rushed in but I was told I would have to come in and stay at 38 weeks.
Then I went into hospital (broken hearted to leave my toddler) with my suitcase. The consultant scanned me again just before admitting me to discover not only had baby moved head down but the placenta had moved clear. So I was let home and put back into midwife led care.
DS arrived 2 weeks overdue and a peaceful (ish) water birth (although he was 9 1/2 pounds so there were a few minutes where I freaked and swore like a trooper)
Good luck. Hope this helps

[captainbarnacle]

They found it at my 20w scan. Told me to come back at32w. I was not told any of the above - I had sex, I looked after a 4 and 2yr old on my own. At 32w they diagnosed PP, and 4 days later I started bleeding and dialled 999.

The bleeding was enough to go through knickers and jeans, but nothing much more than that. A normal sanitary towel in your handbag should suffice. It was because the bleeding didnt stop and it was mixed with my waters that they got DS3 out

[Ktay]

Thanks everyone, obviously it's still a big unknown quantity but between you you've managed to answer all my questions. Feel a lot better about carrying on as normal now.

[glitternanny]

I just posted but thought I'd put it here too I asked my mw yesterday at 31w if she could tell where it was and she doesn't think it's moved, 3 more weeks tO wait.

Good luck everyone!

[Ktay]

Oh bummer glitternanny . Can she really tell without a scan?

[Panzee]

It was fairly obvious that my placenta hadn't moved late on because of where my son's head was, pointing to my right hip. He couldn't get head down because the placenta was in the way.

[aethelfleda]

gitternanny, there is no way your midwife can tell where the placenta is without x-ray specs!!!

She may have thought baby was high up and guessed, but given that the placenta only has to be 2cm clear there'a no way she could tell that from looking at you.cross fingers for the scan and grr if the midwife worried you.