Low-lying posterior placenta at 20w - anything to do except wait?

[Sophia1984]

Hi everyone,

i had my 20 week scan today and saw my healthy, wriggly boy bouncing around. Only issue was that midwife thinks my placenta is borderline low-lying. It's also posterior. She didn't seem worried at all, but booked me in for a scan at 32 weeks to check it. She seemed pretty convinced it will be out of the way by then. I didn't get told anything about resting etc. so I'm left wondering if there is anything I should or shouldn't be doing? I don't do any vigorous exercise but have been doing pregnancy yoga and really hope I can continue doing that. I'm also not sure if I can still have hot baths, as I have been really enjoying these! Anyone had this (especially a posterior one) and have any tips?

Thanks!

Hi Sophia! Sorry I forgot to reply to this on our thread. Posterior placenta just means it's on the back wall of the uterus, so that's fine - all placentas are either posterior or anterior!
If your placenta is only borderline low-lying, it's almost certain that it'll be safely out of the way by the time you're full-term. Basically, if it was covering/too close to the cervix at term, there'd be a risk of bleeding/rupture when the cervix started to dilate during labour. However, in the vast majority of cases, as the uterus grows it pulls the placenta upwards and away from the cervical opening, and thus presents no risk whatsoever when labour starts. Seeing as yours is only just low-lying, I'd put money on this being the case for you.
Personally I wouldn't do anything differently. It doesn't sound like you're doing anything too extreme anyway. You definitely don't have to give up your baths!
Fwiw, the condition when the placenta is over/too close to the cervix is called placenta praevia - but I'd recommend not googling as there's probably heaps of horror stories! I really, truly wouldn't worry, it's very common at this stage and self-resolves in the vast majority of pregnancies.

Haha too late - was googling on my phone as I left the hospital! Seems like the word get used interchangeably far too much! Felt like there was massive disconnect between how chilled out the sonographer was, and descriptions of how serious it can be. I also read that posterior placentas are less likely to be pulled out of the way but I don't know how true that is.. It's hard to remember the positive stuff she said when she hasn't written it on the notes, cause I end up thinking I imagined what she said about it being borderline. Really need to chill out. Plus side is I get lots of monitoring I guess...

www.nhs.uk/chq/pages/2596.aspx?categoryid=54&
According to this, 90% of low-lying placentas have moved up by late pregnancy. The sonographer will have been chilled out because it really is common at this stage, and really is nothing to worry about. i would honestly just treat it as an extra scan and a bonus chance to see baby. I'm not 100% sure, but iirc the 'safe' distance is 2cm between the edge of the placenta and the cervical opening, so you're talking tiny lengths for all to be ok! It's good that they're keeping an eye. Full-on placenta praevia can potentially cause some problems in pregnancy (mostly bleeds), but yours isn't likely to be any bother at all. Don't worry yourself over it!

Sophia, would you be able to link to the place you read the thing about a posterior placenta being less likely to move? I also have a low lying placenta, although the concern in my case is that it was over my previous c section scars at the last scan, which can cause placenta accreta. I'd be interested to read whatever you found about the placenta moving.

I'm 28 weeks now but also had a posterior low-lying placenta at 20 week scan, and am waiting now for scan at 32 weeks. I feel totally fine and have not adjusted anything for it. I read somewhere about posterior being less likely to move too, but I still think the odds are strongly in favour of if moving

Sophia I am in exactly the same position as you, and glad you asked as Fours advice is really reassuring.

I have a 16mm clearance at the moment so hoping it moves 4mm.

Thanks everyone. I am feeling calmer about it today - just did too much Googling yesterday.

Artioo I can't find any detailed sources for it, just the throwaway line on forums with no medical backing! I just found this (small) study which shows that even with a previous Cesarean, the placenta resolved itself in 61% of cases, so while it is less common than without previous Cesarean, it's still more likely than not

The most important thing for all of us is that it's been spotted and we are getting extra monitoring. It sounds like it can be dangerous if you aren't aware of it and try for vaginal birth, but we've got doctors advising us on what is best

I was one of the few % who don't move - I had more monitoring and it turned out the foetal vessels were over the cervix too. I had to have an early term section but it was ok. I lost a lot of blood as the placenta was anterior and they had to go through it.

There's over a 90% chance it'll move, but if it doesn't, it's really not a problem. However, if you start bleeding you need to go to hospital immediately

Thanks Zaurak. Glad it worked out ok for you- must have been very stressful. Am going to have hospital bag ready, keep my notes with me and have taxi on speed dial in case.

Hi

I had my 36 week placental scan today and mine is still low laying but 3cm clear. Our trust will do a c section at 2cm or less so I'm delivering vaginally next week (induction at 37 weeks-unrelated to placenta previa). Try not to worry-mine has been low my whole pregnancy and I have had no problems at all caused by that.

Thanks Champagne That's great to hear you haven't had any problems - I've read so many horror stories and felt like I should set up camp outside A&E! Best of luck for next week x

I had this at the 20 week scan. Have another scan at 34 weeks but yes, in 90% of cases it grows up with the uterus.

I did have a bleed at 27 weeks (I'm 30 weeks now) and got monitored overnight at the hospital. I'd been told to go straight in if I started bleeding.

My placenta was completely over the cervix at 12 and 20 weeks. Was told not to have sex. Had several bleeds early on.

Due to health reasons I had several extra scans and the placenta was well out of the way by 32 weeks.

Hello, I started a thread recently on Childbirth section about this "Grade 1 Placenta Praevia", might be useful to see. Turns out mine is also actually only low-lying too. Now 36 weeks, it's 3.2cm away. I looked at all the risks in great detail because was being told I had to have an epidural just in case of emergency (French hospital attitudes...).
It's probably not going to move much more by this point, but with the distance I have to the cervix, my risk of a serious haemorrage or retained placenta/manual extraction is only 1.1%, which is 2-3X more than a normal placenta location. This risk increases the closer to the cervix it is, and is obviously much more serious if it is covering it at all.
So I decided not to have an epidural in case it creates its own complications, and just go for normal vaginal birth, although I'll maybe try to labour on knees to avoid baby putting pressure on the placenta as mine is also posterior/right.
It's more than likely yours will be only marginally low by 32 week scan, and you can always ask for another one nearer to birth to double check. Good luck!

Sophia I was told the same, she gave me the same figure about 90% of them moving and not to worry. So happy your scan was all good. Let's hope everything else goes smoothly now! If anything we will get to see our babies again before they are born

Hello, I have suffered grade 4 placenta praevia twice.
Most cases resolve themselves, mind didn't happy to answer questions

Thanks everyone :-) Hopefully it will budge out the way but if not, that would be great if I could ask you questions AuditAngel

Does anyone know if there's any reason I should avoid using an exercise/birthing ball during prenancy because of this?

Not that I'm aware of. Nobody told me to! I think if it's covering they tell you to avoid sex but if they've not told you to then it's fine afaik.

Most of them move. Mine didn't move quite far enough, so I had an ELCS at 38 weeks.

I would just advise checking very carefully what hospital policy is if it doesn't move far enough. I had a scan at 32 weeks and it was borderline, but they cancelled my consultants appointment and booked me in for another scan at 36 weeks. Saw midwife at 35 weeks who said no point in doing birth plan until after the scan, and she would see me at 37 weeks to do it.

Scan at 36 weeks showed placenta still hadn't moved enough. Consultant, with absolutely no warning, asked if I was coming in immediately or the next day. Turns out its hospital policy in my area to admit you at 36 weeks in case of early labour or major bleeding, which is very rare but can be catastrophic. And you're in from that point until the baby is born.

I was totally totally fine and so was dd, it was a really calm c section, but I hadn't even started maternity leave and dh and I lost all our "lasts" because I was suddenly in hospital. It was really quite traumatic to have no warning. So do check what the policy is in your area!

Mine moved by the 32 wk scan. I was given a leaflet which said no sex.
It was nice having the 32 wk scan as we saw baby had a full head of hair and Chubby cheeks!