Total placenta previa; feeling a bit fobbed off (but it's probably just the hormones!)

[Drinkstoomuchjuice]

Hello!

Had my anomaly scan on Friday and I have posteria placenta previa, but it is full coverage. That is all the sonographer said, and told me to ask my MW if I had any questions. I rang my midwife today, and she said that she would see me at 28 weeks, and I would be re-scanned at 34 weeks, so I should ring back next month for an appointment. I had already gathered this from the one line on my scan report, so feel a bit silly ringing now.

I'm a bit nervous because I had 3 early miscarriages 6 years ago, and this is the first time I have managed to conceive since then, so I don't want to do anything "wrong". I did some mumsnet checking over the weekend and other people with total coverage have been told to take it easy (i.e. no gym etc). I joined a gym on the m/w's advice, as that way I could have my workout plans tailored to pregnancy. She has said that going to spin classes is fine (I used to road bike before I got pregnant, so have loved my spin classes, but I am not so sure about going now-apparently cycling is one of the no-no sports if you are PP). So now I feel a bit silly, as I'm really nervous about going to the gym, and they have said that I can cancel my membership as long as it is under medical advice, but the midwife has said keep going.

I had one bleed at 10 weeks, but haven't had anything other than poorly-tummy-type cramping and lower back pain since then, so we have been lucky. Dp won't talk to me about it, he just says that everything will be fine, but has now gone into not talking about the future mode; I made a joke about the baby having good legs so she may be a good cyclist, and he shut down and just said "it isn't even a baby yet; stop thinking so far ahead, we've got another 20 weeks to get through before it's even born. Anything could happen", so that blasted any positivity I had out of the water for a while.

I'm just feeling a bit lost really; I'm on medication, so have had lots of scary boilerplate warnings from medical staff about the damage it could do to the baby (the scan shows no issues though thankfully), I was desperate to breastfeed, but have been told that I must bottle feed, so am feeling like a second rate mother over that because I can't even try to BF. and now I'm worrying about bleeding and potentially losing the baby. I was a bit gutted that we are possibly looking at a caesarean, but I'm over that now; I just want her here safely.

Any advice anyone could give would be great, as I feel like I'm making a fuss over nothing due to everyone's reactions when I ask about it.

[Joceshe]

Were you redirected to the day assessment unit for further guidance after your scan? I only have a low lying placenta and was sent after my scan and was given leaflets about the condition and midwife also went through the condition. Was told no sex, flying or physical activity and my placenta was only low lying not touching or covering. I personally would avoid exercise and would request guidance on what else you shouldnt be doing.

[MoonlightMojitos]

There seems to be such mixed advice on this, there was another post recently. Mine is low so I'm going for a rescan at 36 weeks but it's not covering. I wasn't given any advice whatsoever. She just mentioned it's low so to rebook for then and that was it. It was only when I got home and Googled that I read about things you should avoid. In my case I've continued as normal until told otherwise with dtd, exercise etc and havnt had any problems (now 25weeks) but in your case with it actually covering, not just being close, and with a previous bleed I'd also be tempted to play it safe and avoid and seek a 2nd opinion. Is there a general number for local midwives you can ring and ask (don't mention you've already asked one midwife and hope she doesn't answer?!) Or just ring her again and straight up say you're concerned can she definately clarify you shouldn't be avoiding anything? Good luck.

[Drinkstoomuchjuice]

Thank you both for replying. I haven't been referred to anyone; just told to wait until the 34 week scan, but it was most definitely fully covering, the sonographer pointed everything out to us as she saw it, but when dp started asking questions she told him that she couldn't answer them.

I see another nurse for a non-pregnancy related thing, and so mentioned it when I saw her today as she asked how the scan had gone. She too said "play it seriously safe as the baby isn't viable yet if anything does happen." I just feel like I'm being a stupid worry-pot as my midwife was so blasé about it, and made me feel silly for asking, but this baby has been so longed for that I don't want to jeopardise her in any way. I'll ring again tomorrow and be firmer!

[Joceshe]

You are not being silly for asking questions. Im shocked that youve just been told about the rescan and have had to research the condition yourself. Some women have had to be put on bed rest due to a fully covering placenta due to risk of bleeds so its no joke at all. I would definately enquire about sex and physical activity because those appear to be two things that can increase risk of bleeds. Some women have even been advised not to orgasm at all due to the uturus contractions causing bleeds. I hope you get the guidance you deserve.

[quarkinstockcubes]

At my 20 week scan my placenta was completely covering my cervix, was told it could still move and I would be rescanned at 30 to check.
I had a bleed at 26 weeks, was prepped for c/s as my cervix was dilated but tried to hold off to let steroids work on baby's lungs. To cut a very long story short I stayed in hospital for 12 weeks as I was diagnosed with PP type 4 (total obstruction of cervix) and apparently it is high risk for catastrophic haemorrhage. I was on total bedrest the whole time and consultant told me that had I been at home the baby would have been born much earlier as movement/exercise will aggravate a bleed.
I saw many women with PP over that time, most got to 36 weeks before the big bleed but I know when placenta is anterior they are extra careful as obviously baby is less accessible during c/s.
Due to your history I would be wanting to have a rescan before 34 weeks, no harm in asking midwife.

[quarkinstockcubes]

Sorry meant to add that some women with type 4 never had a bleed, but still had to be admitted for complete bedrest and got to 38 weeks.

[Sunshinegirl82]

I had a low lying placenta and had two mid trimester bleeds that saw me hospitalised overnight for observation. I was obviously terrified. I too felt a bit fobbed off as they seemed so blase about it! In the end I persuaded the midwife to refer me to the consultant. Consultant ended up signing me off work for 8 weeks and recommended taking it easy, no sex, no heavy lifting, no exercise. She seemed to take it more seriously than anyone else I saw.

I would push for a meeting with the consultant if I were you, if only to put your own mind at rest. If no joy with midwife try the gp. In the meantime I would take it easy as that way you'll know you're doing everything you can if you see what I mean.

If you do have any bleeding call maternity triage straight away. If heavy, call an ambulance and tell them you have a low lying placenta.

Although I spent most of my pregnancy in a state of panic it was ultimately pretty uneventful and ds was born safely at 39+5 and is now 7 months old! But I totally get the feeling of no one seeming to get the seriousness of the situation, I would definitely push for closer observation. Good luck!

[quarkinstockcubes]

Coming back again just to say that my consultant told me that a low lying placenta at 20 weeks has a really good chance of moving up but one that is covering cervix doesn't. It may move up a bit but will still require a c/s.

Regarding dr talking like that, that is really disheartening and unprofessional! I saw loads of doctors over my stay and there were a few who were complete misery guts. For future appointnents you can request to see a particular dr or request not to see a particular one.

[reikizen]

You should have booked a 25 week appointment with your midwife if it is your first baby, you can also make an appointment whenever you want so why not do that? You can discuss it there. Unfortunately there is nothing you can do to change the position of your placenta, it may well alter as the uterus grows but a little bit of info about what it does and doesn't mean would have been nice! Don't worry about exercise etc, the main thing is ring your triage (or whatever emergency service your unit offers) if any bleeding from your vagina and explain you have placenta praevia totally covering the is (opening to your cervix). However, I cannot stress strongly enough that mumsnet is absolutely not the place to get info about serious issues affecting you or your baby's health, you may get false reassurance or be sent into an unnecessary panic. Your own healthcare providers know your personal situation, get used to asking questions when you are actually at appointments. Good luck

[Nan0second]

Obstetric Consultant here. Just wanted to point out that I have never put any one on complete bed rest for major placenta praevia in my life.
It is not unreasonable to avoid sexual intercourse but not compulsory unless you have had a bleed.
Exercise is fine but should be gentle and what you normally do outside of pregnancy.
cycling is fine and no worse than any other form of exercise.
Talk to your midwife at your 25week appt.
A rescan at 34 weeks is fine - they will do it sooner if you have any significant bleeding. Otherwise better to wait as it will give the team the most info regarding planning delivery.
Best wishes.

[quarkinstockcubes]

Really nan? My hospital's policy was anyone with type 4 pp was not allowed to leave the ward (to go to hospital shop) unless accompanied by midwife and we had to have a functioning venflon in at all times. They went to great lengths to explain about seriousness of haemorrhaging.

[haveacupoftea]

I've a low lying placenta, in the lowest centile but not covering cervix so not as bad as your condition. But they didnt give me any instructions at 20 week scan either just booked me a consultant review at 34 weeks. I have midwife on wednesday and consultant in 2 weeks anyway so will ask about it then.

[Nan0second]

Quark. Yep no admissions for placenta praevia here unless there has been bleeding (and that may be just overnight or until the birth). Even then, they go to the shop by themselves... (it's just downstairs)

[Chrisinthemorning]

I had pp. It was touching not covering.
I had lots of bleeds. The first was at 23 weeks and it was quite heavy. I ended up taken in by ambulance. I did bleed throughout the first tri as well but not due to pp.
I had about 4 more. Had the steroids. Each time I was discharged after a few days, but they did say that was because the hospital is fairly close.
I avoided sex, exercise, swimming etc. I wasn't on proper bed rest because there is a risk of DVT. But I took it easy.
Big bleed at 35 weeks, admitted for a week and DS born at 36+3 by EMCS, 3 hours before booked ELCS because I had another bleed.
I didn't bf, DS couldn't do it because he was too sleepy. I'm not an improper mother though He's now 4 and I was told last night at parents evening that he's a superstar. Proud mummy
Good luck. I would ring and book a mw appt, surely you should be consultant led now anyway as high risk so they need to sort that out?

[Sunshinegirl82]

I think part of the difficulty is that different consultants have different tolerances and different hospitals have different policies. So when you hear that people have been consultant led and admitted to hospital for bed rest and you've been told to basically crack on with no real guidance it feels like maybe you're missing something?! Plus, it does sometimes happen that people slightly fall between stools in the nhs on occasion so I think you do need to check sometimes that you're on the right track.

After the first bleed I was a mess, beyond anxious. I needed to see the consultant for my own peace of mind really. She then took it quite seriously and I had scans every 4 weeks until delivery with instructions to induce on my due date if I hadn't gone into labour spontaneously by then. Obviously she made this decision based on my personal medical situation and it may not be the same for you but I don't think it's at all unreasonable to want to talk to someone in detail about a diagnosis of placenta previa so if you feel it would help I would make an appointment with the midwife and see what she can offer you.

[mistermagpie]

My cousin had this and following a bleed at 32 weeks was put on complete bed rest in hospital for the rest of her pregnancy, this was only last year. It seems to vary then if others are saying this wouldn't happen because at our local hospital it was taken quite seriously.

Saying that, prior to the bleed at 32 weeks they didn't know it was fully covering the cervix (not sure how it wasn't picked up at the scan) and she carried on life as normal. She has two other young kids so certainly wasn't taking it easy! Her baby was completely fine by the way.

I would want more advice to be honest. Make an appointment to see your midwife now, they will see you outside of the standard appointments, and push for a proper explanation.

[Applesandpears23]

Regarding the breastfeeding and medications. You may want to get a second opinion from the Breastfeeding Network drugs helpline. www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk/

Lots of women are discouraged from breastfeeding due to medication even though for some medications the risk of breastfeeding with the medication is still lower than the risks associated with formula.

[quarkinstockcubes]

I think part of the difficulty is that different consultants have different tolerances and different hospitals have different policies.

^This. After the morning rounds of consultants we used to get together and compare notes, sometimes it seemed that the consultants were poles apart, which added further to everyone's confusion. My consultant said type 4 PP was a time bomb waiting to go off and I had to sign a form saying that in the case of catastrophic haemorrhage she would not wake me up from the GA (policy in our hospital for pp) to ask for consent before doing a hysterectomy. Looking back it was presented as something really frightening and it really wasn't that bad. Apart from the long hospital stay the worst bit was wearing the TED stockings for 10 weeks in the height of a summer heatwave.

[Drinkstoomuchjuice]

You are all brilliant, thank you. I am overly cautious at the moment; dp and I won't be living together full time for another 2 months, and I'm 45 mins from the hospital, so I am a bit worried about what would happen if I bled in the middle of the night on my own (I have a 12 year old dd at home and the dog to arrange care for). I will ring again today and see what they say; because she isn't my first my midwife said that she would see me at 28 weeks, not 25, and it would reassure me to see her a bit earlier than that.

The bottle feeding is more to do with the amount of rest I get; if I get too exhausted I end up in hospital for 2 weeks, so I can still express (I got on to the Breastfeeding network and they were brilliant!), but the advice is that the baby should be bottle fed so that she can still feed if/when I get taken in or desperately need a sleep, so that she isn't suddenly being introduced to a bottle out of the blue.

I just want everything to be ok; I was enjoying being pregnant up until this point, and now I just want it to be over so that I can have her here safely. Every little tug and stretch in my tummy makes me worry now, and I thought I was able to leave that behind at 12 weeks!

Thank you all again, you are such great ladies xx

[harleysmammy]

Im not 100% sure on this but my sister has the placenta completely covering the cervix and she was told to take it VERY easy by her midwife but they only put people on complete bed rest if they bleed after 20 weeks because of the placenta. Again im not 100% sure but i did go to all of her appointments and remember her having a bleed and only then did she be put on complete bedrest. Before her bleed the midwife told her not to lift anything heavy including my 1 year old niece, dont do any heavy housework like hoovering or on all fours cleaning, no running or exercise. That was her doctor mind so it could be different for all doctors x

[Drinkstoomuchjuice]

I spoke to my midwife today and the conversation was totally different to yesterday's, which has reassured me a bit. She wants to see me at 24 weeks, and I'll be scanned at 28, 32 and 36 weeks. Still no info on taking it easy, but I'm going to do that anyway. Come on lady luck, you gave us a baby at last, let us keep her safe and sound!

[Sunshinegirl82]

I'm glad the midwife has reassured you. If it helps, even during bleeds ds was spectacularly unbothered! His heartrate never faltered! I found I was calmer once I got to 24 weeks and calmer again at 28 weeks. Best of luck!

[rhubarbcrumble66]

Hi, posted on this recently. My placenta was completely covering cervix at 20 week scan. I am booked in for another scan and consultant appointment at 28 weeks. Currently 25 weeks and no bleeds so far. I wasn't given any specific advice even when I phoned to speak to midwife but she did say sex and flying may not be a good idea, so kind of down to me to determine what level of risk I.m happy with. I've been trying to take it fairly easy and decided against foreign hol I had planned for 27 weeks. Hope all remains stable for you; it is frustrating how much conflicting advice there is on this.

[AuditAngel]

I have the dubious honour of achieving grade 4 PP twice!

With DD1 (DC2) I was diagnosed at 22 weeks, given no advice other than to contact labour ward in event if bleeding. Admitted with bleeding at 33.5 weeks, in for 2 days, sent home but back within 24 hours until born by planned CS at 37+4

We asked if there was any reason it would happen again, "oh no" we were told.

With DD2 (DC3) I was disguised at 21 weeks, admitted at 24 weeks, 26 weeks, 3times at 31 weeks, then finally at 33 weeks I was kept in. I was told at 21 weeks no flying, no lifting the children, no pushing shopping trolleys. At 24 weeks I was told no more work. I laughed at them. Was signed off for 2 weeks, then readmitted after an hour back at work.

Eventually had EMCS at 36+1