Urgent info needed please! Placenta previa - any experiences?

[Rhubarb]

I've got this in pregnancy too, but I really need advice so thought I'd stick it in here.

For someone who cannot access Mumsnet.

She is 35 weeks pregnant and has the above condition, probably grade 3 or 4. She was told rather abruptly by her consultant that she may haemorrhage and then bleed to death. This consultant wants to to change to a different consultant as he wants to pass the responsibility onto someone else.

The earliest date they have offered her for a section is the 6th of February. She could book herself into hospital until then, but she has 2 small children at home and no-one to look after them for her.

She is suffering from ante-natal depression because of the stress and the consultants and hospital are being extremely unhelpful and unsympathetic. They've basically told a pregnant mum that she'll probably haemorrage at home and bleed to death.

Any advice would be very very gratefully received and we'll make sure she gets the advice asap.

Has she had any bleeding during the pregnancy? Are they telling her that she could bleed to death at home because they want her in the hospital? I would suggest she contacts either AIMS or the PALS at her hospital.

They are covering their backs. The risk of bleeding with placenta praevia is high but it isn't a foregone conclusion and the levels of bleeding vary from minor to what they term 'catastrophic'. I had partial praevia (half over my cervix) that moved away by 30 weeks but was still low (still classed as Grade 2 I think) and I bled constantly from 23 weeks onward. This triggered labour on several occasions which they managed to block.

Some bleeds were small - frightening but stopped after a minute - and others were massive; like turning on a tap. They did stop but sometimes they don't and my Consultant was at pains to put the fear of GOD into me about this, as if you're at home and you get one of these bleeds then you have a very short space of time. He termed them 'catatrophic bleeds' and told me, "Mrs Kitstwins, you could lose all the blood from your body in five minutes". Not great to hear. It's very, very rare that this happens but it isn't unheard of and they have to warn you of it.

I was in hospital from 30 weeks onwards because of the bleeds and had my final, whopper bleed at 35 weeks, at which point they delivered my twins by em c-section. But I think I was just unlucky. I have a friend who was also having twins and had Grade 4 PP (total coverage of her cervix) who didn't have a single bleed for the entire duration of her 37 week pregnancy.

As I see it your friend doesn't have many options as she has small children. Yes, she could book herself into hospital and sit out the next couple of weeks, but who would look after her children? If she doesn't have childcare then all the nagging in the world from consultants isn't going to help her. It sounds as if her consultant doesn't want the responsibility. She CAN'T stay in hospital because of her children but if anything did go wrong he could be held responsible and he probably doesn't want that.

There is a risk with praevia of these 'catastrophic bleeds'. They are rare but they do happen and unless they happen when the patient is at hospital (and with access to theatre and blood) the outcome can be disastrous. Loss of either or both the baby and mother's life. However, if your friend hasn't had any bleeds to date then that is good news as it's less likely that bleeding will occur and, equally, much less likely that a catastrophic bleed will occur. The risk IS there with PP though and the consultant will want to cover his back on this.

I'm not sure what patients do in that situation. I was lucky as I didn't have children to worry about so my issue was more the headf*ck of being stuck in hospital for the last five weeks of my pregnancy (I went mad & got very depressed) but the hospital will surely have someone who can advise. AS Daisymoo says, try PALS. It's a good place for her to start.

K.

Can't advise w. most of this but I think she should change consultant asap cause her current one sounds like a complete arsehole. Hopefully a new consultant will provide more help and support.

Having said that, if they are advising her that it is really a matter of life and death (specific concerns related to this pregnancy rather then placenta pravia generally) then really she must go into hospital. If really no friends/family who could help in such extreme circumstances then she could contact social services re: emergency foster care. V. traumatic for the little ones but less so than losing their mum iyswim.

pp can be managed at home if you have not had any bleeding but she would be wise to take precautions. have mobile phone on body (and charged!) at all times.

do not do anything strenuous or any lifting. do not do anything like climb a ladder hat could result in a fall. do not play football or anything rough. take it very easy. do things slowly.

if possible have a friend round for a bit or visit a friend or neighbour close by for part of the day. Does she have a friendly neighbour that can be alerted if needed? are the children old enough to do this?

she needs to plan what to do if a bleed does occur.

I've come accross people who have been advised that it is ok to stay at home as long as there has been no bleeding, but as soon as there is any bleeding they must go to the hospital for the rest of the pregnancy.

yes the current policy is that it can be managed at home whilst no bleeding otherwise all the maternity units would be full up with women waiting for several weeks until they give birth.

you can stay home but you need to be careful and be prepared for the worst to happen. home alone is not advised but it is up to your consultant to make you aware and access your risks.