CS for placenta praevia- experiences?

[blacktreaclecat]

I have a posterior placenta praevia close to os. Off work on modified bed rest after 2 small bleeds.
I quite fancied ELCS anyway for various reasons but am now scared of the increased risks of bleeding, hysterectomy, having to have a GA (not scared of GA itself- had quite a few but I want to be there when my baby is born!).
Obviously my biggest worry is that our precious longed for baby will be early and poorly (27+5 ATM).
Any birth stories?
Thanks

God who have you been listening to re cs? Why would you have a GA? Why would you be at risk of needing a hysterectomy?
If the placenta is v low you'll be having a cs anyway so the choice is out of your hands really.

I had placenta previa with my first baby and had a very calm, quick, painfree delivery with a spinal block. Recovered v v quickly, all fine. What has made you worry that ELCS won't be like that?

Hi bagofholly
(Ayla friend of Goldfish from DW here- sounds like some bonkers code but YKWIM)
Really I'm worried about the pp causing a big bleed leading to EMCS. I know sometimes with EMCS there isn't time for a spinal.
I wanted ELCS before this anyway as I have a lot of anxiety about childbirth and I wanted the birth to be a very calm, planned procedure which a vb for a first baby may well not be.
My consultant wasn't very reassuring at all about the pp and has scared me to death about baby being very early- 27+5 at the moment.

Wow hello! Fab to hear from you!

Honestly, I think you're (understandably) overthinking. Firstly loads (over 90%) of pp resolve themselves by term, and even if they don't, it's rare to actually haemorrhage. The risk is if you labour naturally, then yes, they have to get the baby out fast, but overall that's a low likelihood. I'm sure there are loads of studies looking at this, I'd have a look but am twinwrestling!

I totally get wanting ELCS - although mine was for pp first timed already requested one for the same reasons as you.

You do sound worried, so it might he worth considering a second opinion, maybe privately with a different obstetrician who can walk you through the realities of it. Have you got private health insurance? If so it should cover this, plus a private cs too! We did this. I was out if my mind with fear when I had T and didn't totally believe itd happen till I saw him come out.

Hope you're well and great to hear you're v pregnant! X x x

you say that the pre via is close to but not touching the os? it might be in another few weeks, it might have actually 'moved' further away from the os as your uterus stretches up?

i think GA is last resort for serious pp over the os?

if your consultant is not being reassuring you can ask for a second opinion or to see someone else

also perhaps consider speaking to consultant midwife or supervisor of midwives?

Thanks both. At present I'm under a fetal medicine consultant because I had to have tfmr for t21 last time. She is lovely but wouldn't be the surgeon anyway- she isn't a surgeon. Also she did miss it- I had scans at 7,9,12, 16 and 22 weeks and the pp wasn't spotted until after my second small bleed last week. The sonographer put on the scan report part covering the os but the consultant did a TV scan and put touching os?
I do have Bupa. I rang them yesterday. They will pay £500 ish to the surgeon and £300 ish to the anaesthetist for CS for pp. But around here (Yorkshire) there would be no private hospital that could do it so it would be a private cs in an NHS hospital. The consultant would be the same so don't see a lot of benefit going private - the Bupa fees may not cover the costs and the treatment would be exactly the same. They won't pay for a private room antenatally but if I end up admitted for weeks as I think a lot of pp patients do, I think the NHS give you a side room anyway. A month on an Antenatal ward and you'd be a basket case from lack of sleep. Bupa will pay for a private amenity room up to 4 nights postnatally and I will use that benefit if at all possible.
This is all complicated by the fact that we move on 3rd May (well H is doing the move, I'm going to stay at my mums until all is sorted!). So will be booking at a different hospital at 31 weeks. I could ring the new hospital and speak to the supervisor of mw there?
I know I'm panicking but all was going so well after 3 years of trying. I was just starting to relax and enjoy being pg and now this!

I have just had an ELCS for placenta praevia due to posterior placenta covering the internal os. I was in hospital at 34 wks overnight after a small bleed, was allowed to leave as long as I stopped work and barely did anything, at 36 wks I had another bleed and was then in hospital for two weeks (in a side room) awaiting the birth - they didn't move the date of the section, but I was told that there was a small chance they might if I had lots more bleeds, or there was a risk of an emergency section if I had a major bleed.

When the anaesthetist and consultant went through all the risks with me it did feel a bit scary, but a lot of what they were saying was to do with things that were very unlikely (e.g. the chance of a hysterectomy). You will have a consultant do the surgery, because it's a little more complicated than other sections, and they have lots of tricks for making sure that you don't bleed too much, and that they are prepared for any bleeding you do have. I lost around 600ml of blood, a 'normal' section would average about 500ml - so not much different. It's more complicated if you have an anterior placenta and a VB can be far riskier (depending on how close the placenta is to the os) - there was no way I could have gone into labour.

Really, there's nothing you can do about any of the risks except trust the medical team (who have done this before!). If they need to give you a general anaesthetic, it's because they need to give you one in order to safely deliver the baby and realistically you're not going to want them doing anything else. Try to focus on the end goal here and worry less about things which are not important in the grand scheme of things.

I can`t help but understand the DW code & am thinking of you.

I had a cs for placenta previa at 36+5. Was in hospital from 33 weeks due to bleed but IT WAS FINE! The CS was done under spinal so I was awake, and was a wonderful experience. It was the best day of my life. My baby is absolutely fine and I recovered very well.

There are obviously risks with placenta previa, but the doctors know about it and that is the importnat thing. They can manage those risks.

Good luck.

"close to os" is very good - at 27 weeks there's a fair chance it will move. It is when is is "covering the os" that the odds aren't so good.

I had a cs at 34 weeks for placenta praevia; started to bleed, hung around on labour ward for a few hours with them saying "ooh, it'll stop soon" and then I started having contractions so it was off to theatre with me. They were discussing GA over my head on the way there, and I was not enjoying the contractions so was quite keen on the idea of oblivion at that point but they decided on spinal. They didn't tell me that, I was very confused when they were doing it. But I did get to see ds1. Only in passing - he needed to go to NICU so the nurses kind of waved him at me as they went past. He was in NICU/SCBU for a week and then with me on the ward for a week and then we both went home. He's now 7 and fighting with his little brother (also placenta praevia and cs and NICU!) over the Wii at the moment.

You may have a big bleed - keep your phone handy and a bag packed and don't decide to paint the nursery or climb any mountains. I have had two ambulance rides now while bleeding merrily away; baby was totally fine both times (as was I).

The GA/hysterectomy scenario is usually when you have placenta accreta/percreta as well. I'm guessing they've looked for that and don't think you're at risk or they probably wouldn't have let you go home.

Having a prem baby is obviously not great but, also not that likely for you at this point - think nice calm thoughts and stay off Google!

Just seen that you're 27+6 now. I was on the antenatal ward from 23 weeks with ds2 (had the percreta thing). When I got to 28 weeks all the docs and midwives visibly relaxed around me. 28 weeks is the holy grail with a potential prem baby. Sit tight for one more day .

And a GA isn't the end of the world. It's a bit strange, but ds2 certainly didn't notice ...

I had a CS with pp. I was 17mm from the os. Went into labour 5 days before scheduled CS. I had a very very quick labour (went from a contraction every 4 mins to one every 30 seconds in about 45 mins). Had an EMCS and they had plenty of time for the spinal (despite being in labour). It was lovely and relaxed. Chatted with the surgeons and anaesthetist. Lost 500 mls of blood. Had a bath 36 hours later. This was 11 weeks ago. Scar has healed to a faint white line. I was v v careful the first month and took all the painkillers possible and healed quickly.