Complete placenta previa with anterior placenta

[MGreen13]

IVF pregnancy here and currently 23 weeks. We've ended up with complete placenta previa as well as an anterior placenta (checked at 16 and 20 weeks with zero movement).

Two Consultant sonographers have both said they really don't think this one is going to move. We're still manifesting that it might but it likely won't... this means a planned c-section at 36/37 weeks. Fine by me.

I'm taking 150mg aspirin cause I also have low PAPP-A (determined from our combined screening), and taking aspirin helps the placenta blood flow and reduces risk of pre-eclampsia.

Due to placenta location, we've been told I might have a 'warning bleed' which is a good indication that I'll have a bigger, more dangerous bleed later. Really hoping that doesn't happen but, if it does, I'm to stop taking aspirin cause that will make the bleed worse.

I've read that with complete placenta previa, an anterior placenta (vs posterior) is the worse of the two possibilities and makes even a planned c-section delivery very high risk.

Anyone else had an anterior placenta with complete placenta previa...and low PAPP-A?

How was your pregnancy and delivery?

I didn’t have low PAPP-A and my placenta was sort of both anterior and posterior, which is the worst in terms of budging 😅 discovered at my 20 week scan and had a follow-up scan at 26 weeks where it had not budged at all and the doctor gave me about a 50% chance of it moving. My first was born via emergency caesarean so they were worried about accreta, but could rule that out thankfully. Was scheduled for another scan at 32 weeks.

I had no issues until 29 weeks when I had a tiny tiny bleed, more like brown spotting really. Went in for a check and they confirmed the placenta had not budged, but was given the all clear but told to call in again in case of fresh red bleeding etc.

31+5 I woke up at 3am and felt damp, stood up and blood started gushing out of me… left bloody footprints all over the floor getting myself into the shower (?? weird panic reaction). Called L&D who called me an ambulance. Bleeding stopped pretty quickly with rest and tranexamic acid infusions. Ended up monitored and fasting for 12 hours or so and given steroid shots for baby’s lungs, then was transferred to the antenatal ward where I spent the night and was discharged the following afternoon.

Scan at 32 weeks was converted to a growth scan since they’d confirmed nothing had changed while I was admitted. Baby was measuring +4% and was breech.

Had a small red bleed at 33+3 which got me another 2 night stay in hospital, same procedure as last time though much less dramatic due to much smaller bleed (no ambulance, no continuous CTG etc).

Final scan at 35+3 when they confirmed there was no way for me to have a vaginal birth, complete previa with lots of big blood vessels between the uterus and my bladder (possibly because I had a B-Lynch after my first section). Surgery scheduled for 37+2 as they really did not want me going into labour. Baby still breech and now measuring +16%. Doctor requested experienced surgeons and for blood to be ready in the theatre.

11pm the night before I was due in hospital for my elective I had another massive bleed, gushing out of me even when lying down, big clots etc. Another ambulance ride and monitoring and fasting overnight with them prepared to do an emergency section if needed. Luckily things were quite under control so I went in for my scheduled slot with my highly experienced team. They prepared me for transfusions even before beginning the surgery. Surgery went well, my baby came out very healthy and well (and big, 7lbs 15oz), I felt fine throughout and was quite surprised when they told me I lost 4.9 litres of blood during surgery 😅 they gave me 4 units of blood and two units of plasma. The surgery was very controlled and altogether a very positive experience. My baby was placed on my chest right away and we were only separated briefly as they needed to put heating blankets on me (looking at the photos I’m quite grey in the face at that point) but otherwise we were together the whole time. I experienced minimal nausea unlike my first section when I threw up left and right.

tldr - I was high risk, expected to haemorrhage, lost basically all my blood but everything went fine and it was a very positive experience.

Oh my @tovels that sounds like quite the journey but so glad it ended positively and you and baby are well!

We have since found out that my placenta is also basically equal on front and back and at a 25w scan had not moved at all so probably going to stick there til the end. Also looking a bit 'bilobed' which probably isn't great being where it is but we'll see how that develops!

We had a bleed at 24+5 and had an overnight stay in hospital. It was basically one gush of fresh red blood and then just brown spotting for the next 5/6 days so we got to go home. Managed to not panic as we were expecting something might happen but will get an emergency bag ready to go for next time!

We've also been told to stop taking aspirin for the next week and to take everything SUPER easy for the next couple of weeks, like try not to even walk too far anywhere!

Fingers crossed we make it to 37 weeks as you guys did! Thank you so much for sharing your story, it's really useful for me to hear other experiences 🩷