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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

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Original poster

Placenta previa - what happens if cervix is still covered at scan?

31 replies

TotorosOcarina · 06/02/2011 15:18

Am 27 weeks tomorrow and have a scan at 32 weeks to check if cervix is clear,

If its not, what happens?

will the check again?

Will i need to have a c-section? Am planning my 3rd homebirth!

Thanks

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onimolap · 06/02/2011 15:22

They will keep monitoring.

If it does not move clear of the cervix, then a C-section is definitely needed, as dilation would compromise placental function in a way which can be rapidly fatal, and also can precipitate major maternal haemorrhage too.

Placentas do tend to move up as everything expands, so I hope it'll all look ok at your scan.

Original poster

TotorosOcarina · 06/02/2011 15:27

argh, thanks.

sounds scary but hopefully it will have moved, thankyou x

OP posts:

Dlamis · 06/02/2011 15:32

There is still plenty of time for things to move up and out of the way but if not they will keep monitoring and possibly scan again. I had my scan at 34 weeks.

It may depend on how much the cervix is covered. If it is still completely covered at 32 weeks (or 34 in my case), it is possible that they will keep you in hospital until baby is born by c-section or at least want you to stay in hospital when you get nearer to 37/38 weeks.

Original poster

TotorosOcarina · 06/02/2011 15:46

really?! i didn't realise it was that serious, no ones actually talked to me about it

OP posts:

expatinscotland · 06/02/2011 16:06

You must have a CS if the placenta is over the cervix/os.

onimolap · 06/02/2011 16:08

It is potentially very serious. The following description is not meant to scar you, as with close observation and management, there are no problems. But it might help to know a bit more about the risks.

The baby needs the placenta for oxygen until it is on the outside.  Then it peels away leaving a large wound inside the uterus which is prevented from continuing to bleed when the uterus clamps down after delivery (whether natural hormonal rush or artificial injection).

If the placental is on the cervix, which needs to move and dilate, then it will begin to peel away, long before second stage. This compromises, and in worst case shuts off, the oxygen supply to the baby. This can result in serious oygen-starvation damage or death.

At the same time, the wound from the placenta will bleed (how heavily depends on how much peels away). Until the baby is delivered, the uterus cannot clamp down to stop it. Blood loss can be severe, and in the days before transfusion, fatal. Maternal death is still listed as a complication of unmanaged placenta praevia.

If they say you need to be in hospital - believe them! If you have any early contractions, or even period like cramps, or any bleeding at all, go immediately for an assessment.

But, placentas usually move upwards. Hope it is good news at next scan.

Original poster

TotorosOcarina · 06/02/2011 18:18

So the complications usually arrive during labour?

Will ask my midwife about it at 28 week appointment.

Can I still have sex?

OP posts:

Lulumaam · 06/02/2011 18:23

you can experience complications before labour , such as spotting/bleeding.. sex can be off the menu if you've had bleeding

it depends if it it totally covering the os or just touching

if it is covering, you will have to hvae a c.s for the reasons explained.

you can ask your MW for more information ,especially if you are not clear of how severe the previa is or if yo need ot do/not do anyhting

PaperView · 06/02/2011 18:25

Have they told you how severe it is? There are different grades.

One of the scenarios is that you will be in hospital from 32/36 weeks until delivery by CS. But it really does depend on the grading they have given you.

Original poster

TotorosOcarina · 06/02/2011 18:32

The midwives have never mentioned it.

when i had my 20 week scan the sonographer told me my cervix was covered by the placenta and she would book me in for a 32 week scan.

After that i went to the reception and they told me i didn't need to see the midwife, at my nex appointment (24 weeks) they didn't mention it at all.

OP posts:

freshmint · 06/02/2011 18:36

you need to keep on top of it. as everyone else has said it can be very serious. ensure you get that scan and don't let it be forgotten.
if there is any bleeding or spotting get to the hospital and get scanned. if there is a problem ensure you are then talking to a consultant and not a midwife.
hth

onimolap · 06/02/2011 18:42

Here's a link to the US Mayo Clinic site. It has fuller explanations, which you might find helpful. If you're not sure of anything, ask you MW/obs team.

Lulumaam · 06/02/2011 19:12

is there anything detailed in oyur hand held notes?

elseIlltellyourfather · 06/02/2011 19:19

Glad this was posted, had 20 week scan this week and have the same. Phoned my mw to let her know and, like you OP, no one seems too bothered. As I don't know anything about it I didn't really know what to ask. Have another scan booked for 34 weeks. Hope your home birth plan isn't scuppered OP, fingers crossed. My MW did say they usually move; plenty of time to go yet.

stressheaderic · 06/02/2011 19:21

I had a low-lying placenta. Had 2 minor bleeds at 26 and 29 weeks and was monitored in hosp overnight both times (and advised not to have sex/lift heavy things, strain til after baby born). Had
Had scan at 34 weeks and although it hadn't quite moved entirely out of the way, there was still a tiny lip over the cervix entrance, the consultant was satisfied I could proceed with a normal delivery.
In most cases, it does move up as things expand.

TheFowlAndThePussycat · 06/02/2011 19:24

Hi there, I had placenta previa, grade 4 (the placenta was centrally placed completely covering the cervix). I had my first bleed at 29 weeks, it was a tiny smear, but as I had been told to go straight to the hospital, I did. Two days later I had a massive bleed, literally gushing out, soaking right through my clothes the bed etc etc. I then stayed in the hospital till dd2 was born at 36 + 2, had a em-c-section & massive haemorrhage which necessitated a second op under GA.

Go and see your midwife and find out the exact location of the placenta - if it is still off to one side there is a good chance it will move. If it is central ask to see a consultant. It is unlikely to move in those circumstances and you need some advice.

Any bleeding go straight to hospital. Call an ambulance if necessary. I can't stress this enough.

I'm really sorry but unless the placenta moves right away from the cervix a home birth is pretty much ruled out. The threat of haemorrhage is severe.

Hope everything goes well for you, as everyone has said there is a good chance the placenta will move, but it is wise to be aware of the possible complications if not.

Btw, both dd2 & I are very happy & healthy now, no long term ill effects

Panzee · 06/02/2011 19:27

Mine was a partial covering (grade 3). It was picked up at the 20 week scan, then I heard nothing more - no advice or anything. I had a scan at 32 and then at 36 weeks. I still did aquanatal, yoga etc with no issues, until the last scan when the consultant looked horrified that I had done all this stuff and told me to come to the maternity ward at the slightest twinge.

I was admitted at 37 weeks and had my CS at 38 weeks. It was only to keep me close in case of early labour - I was able to roam the hospital at will and didn't have a canula or anything till the day of the op.

Mine was an 'easy' one though - no bleeding when pregnant and the placenta was behind the baby so the CS was straightforward. If I hadn't have had the scan at 20 weeks I would never have known there was a problem. Try not to panic - ask for a consultant appointment if you're concerned. I reckon they'll call you if they're worried however - the consultant called me the day after the 36 week scan and asked me to see him that day, so he must have been concerned by then.

TheFowlAndThePussycat · 06/02/2011 19:32

Panzee my friend is an aqua natal teacher & wouldn't have me in her class because her insurance wouldn't cover me. It's best to ask before doing any exercise stuff.

Panzee · 06/02/2011 19:33

I did write it on the form! I never thought about it really, the scan had seemed so long ago.

TheFowlAndThePussycat · 06/02/2011 19:38

Oh well, just me then !

Original poster

TotorosOcarina · 07/02/2011 09:01

Oh christ I feel ill now :(

will dig out my notes and see what it says.

My Aunt had it and at her 32 week scan it had moved and she was fine and had a natural labour no complications.

I hate hospitals and after 2 HBs the thought of even being addmitted is so horrible, never mind a c-section :(

OP posts:

Original poster

TotorosOcarina · 07/02/2011 09:10

Right, just looked it only mentions it on my 20 week scan sheet and on the 2nd page, it says :

Placental site ANTERIOR LOW (then it has a U with an arrow above it?) CLEAR FROM OS (little arrow U again) Rescan 32-34 weeks.

any ideas?

OP posts:

Original poster

TotorosOcarina · 07/02/2011 09:18

just found out 'os' means the cervix, so its not covering the cervix its just low lying i think??

OP posts:

Original poster

TotorosOcarina · 07/02/2011 09:18

so i've not got placenta previa?

OP posts:

onimolap · 07/02/2011 10:09

Os refers to the actual hole of the cervix, so saying it is clear means you do not have Grade 4 pp. It may still be over other parts of the cervix (Grades 1-3) and this still requires careful management.

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