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Abdominal pain with anterior low-lying placenta

(7 Posts)
malison Fri 13-Jun-14 14:16:59

Hi, I've just had my 20wk scan and was told I have an anterior placenta which is also very low down, 8mm from the internal os. I know that since I have no scarring or history of previous C-sections the placenta is very likely to move out of the way enough before full term to still allow a natural labour, so I am not that worried about that (or trying not to be!). However I did not know until reading some posts here that there is an increased risk of bleeding as they didn't say anything about that to me. My main concern is that the lower part of the bump/abdomen, below the belly button and particularly right above the pubic bone/hair area (i.e. over where I presume the placenta to be given their description) is pretty uncomfortable most of the time. Not crampy exactly but a dull ache, enough to be worrying, and often gets worse if I've been sitting for a couple of hours like at the computer or on a train, or driving. I often feel pressure low down as well. I do not remember feeling any sort of discomfort this early on in my first pregnancy (which was not an anterior or low down placenta) and I am wondering whether this is caused by the position of the placenta or by something else. The consultant didn't say anything to me at the hospital about this causing pain (I forgot to ask as had so many other things to discuss with her re. size and birth options) so I don't know if I should call my midwife as I won't be seeing her again until 25 weeks and I have been uncomfortable for a few weeks now. I'm supposed to be going to Portugal for work in about 3 weeks and I don't know if it is worth the risk in terms of discomfort on the flight and then the train journey afterwards. Any similar experiences or information would be great to hear.

A bit of context: our first son was born naturally at a home water birth. My waters broke 48 hours before I went into labour but other than that the birth was wonderful and straightforward. We are planning a home birth again but since our first was small (just under 6lbs, on the 4th centile for my height/weight/ethnicity) they have put me down as high risk this time and put me under a consultant. They want to do serial growth scans every 3wks from 28wks to monitor this baby's size (even though scans have a 20% inaccuracy rate for size) and if he is scanning as under the 10th centile they will be "strongly encouraging" (i.e. pressuring) us to have a hospital birth in a labour ward with constant monitoring (my personal nightmare birth). Now with a low down placenta they have another reason to monitor me so I am not happy at the moment! On the up side, I suppose the regular scans in the third trimester mean that it will be easy to have a clear idea of whether or not the placenta has moved. I think the consultant thinks in some ways it would be good if the placenta DOESN'T move because basically then a C-section is a no-brainer so there would be no worries about trying to decide about birth options if the size is on the borderline (say sitting on the 9th centile the whole way). She essentially said as much. Not what I wanted to hear!

Anyway the main thing I'm looking for advice on is this issue of whether or not the pain low in my abdomen is connected to the position of the placenta and whether or not it is something to be worried about. Thanks for reading.

gualsa Fri 13-Jun-14 23:38:41

Hi Malison. I had Placenta previa at 20weeks totally covering the cervical OS. They actually didnt think it would move and it still did! More likely to move if it's anterior. With yours being 8mm away from the cervix it only has to move another 12mm or so which it definitely will. Because it's not covering your risk of bleeding is very low so don't worry.

In relation to the dull ache- I had that a lot during my 1st and second trimester. Turned out I was constipated! Got myself onto lactose and Fybrogel and it cleared up. Any sharp pain could be ligaments but the placenta has no nerves connection with you as far as I know so it won't be that. Could you be constipated or colicky?
It's common in pregnancy.

AnotherStitchInTime Fri 13-Jun-14 23:51:38

Hi, during my third pregnancy (1st two c sections) I had placenta praevia covering the OS with percreta (it grew into my bladder). Apart from the odd twinge where the percreta was I didn't have much pain even when bleeding, so pain doesn't necessarily equate to a problem with the placenta. I had low lying with anterior placenta with my second pregnancy and it moved away from the OS.

The dull ache thing does sound more like constipation, but if it gets worse then a colour Doppler ultrasound sound to check blood flow might be useful to check for placenta accreta. Highly unlikely given you had a natural birth last time.

You don't have to go for hospital birth, you had a healthy baby last time and good labour/birth. Your choice.

AuditAngel Fri 13-Jun-14 23:54:21

With both DC 2&3 I had grade 4 placenta praevia and did not suffer from the pain you are describing. Please contact your midwife.

malison Sun 15-Jun-14 17:11:22

Thanks for the replies. It's definitely not constipation - I'm vegetarian and my diet seems to ensure that even when pregnant I'm pretty much never constipated! (TMI, sorry!) Over the past few days I've noticed that either sitting for long periods or standing/walking around for long periods makes the pain worse, extending down into my upper thighs, and only lying down on my side and resting eases it. I looked up the NHS website on pregnancy and I now think it probably has nothing to do with the position of the placenta and could in fact be the start of pregnancy-related pelvic girdle pain. So I'm going to call my midwife and ask for advice on managing this and preventing it from getting worse as the baby gets bigger, as I'm not seeing her again for another 4 weeks. (I know someone who had the extreme end of pelvic girdle pain where it feels like your pelvic bones are actually separating, and she ended up in a wheelchair for much of her two pregnancies and for a while afterwards - I certainly don't want it to turn into that!) Thanks.

AnotherStitchInTime Sun 15-Jun-14 17:25:17

Yes that does sound more like pgp and sciatica, see if you can get a physio referral as they take ages to come through, best done early.

gualsa Sun 15-Jun-14 19:56:13

You could have saved yourself that huge post if you had started off by consulting the NHS website;-). Hope you get it sorted. Best of luck..

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