Low-Lying Placenta and Holiday

[DrMantisToboggan]

I’ve just been diagnosed with a low-lying placenta at my 20 week scan. Haven’t been given any information as to the degree, location, nothing but a leaflet. My maternity notes don’t have copies of the scan reports and my midwife doesn’t have access to those reports either so she couldn’t enlighten me when I rang her today.

Because I have had a previous c section, I’m due to be scanned again at 30-32 weeks and a plan made for my care if it hasn’t moved.

I’m due to go on holidays abroad from 29-32 weeks - should I be looking to cancel it? The sonographer didn’t seem overly concerned at all, but I’m a bit at the lack of information. I’ve had no bleeding at all, but I gather from the leaflet I was handed on the way out that bleeding can be common and potentially serious.

Anyone have any experience of this?

(I’m also not entirely clear whether a low-lying placenta is the same thing as a placenta praevia or just something not quite as bad. My leaflet seems to use the 2 terms interchangeably.)

Hopeful bump

Hi OP I have this and am flying at just under 28 weeks. I have consultant care as well (for a separate issue) so spoke about it with my consultant. They basically said that standardly they wouldn't recommend flying because the results can be 'devastating' if something goes wrong (i.e. if I happened to go into labour on the plane). But they also said that advice doesn't take into account any other factors. So I'm going but am aware that there's a small risk. If you're flying after 28 weeks many airlines need a fit to fly note. I purposely chose to go earlier both to minimise health risks and avoid the potential risk of not being 'fit to fly'.

Thanks rarely - I’m going by ferry, an overnight ferry. Not sure if that’s better or worse tbh!

Where will you be going on holiday - is it somewhere with good medical care and facilities? I think I'd want more info too about the risks. If you MW knows nothing and you've just been given a leaflet then that, IMO, is insufficient for you to make an informed choice about travelling.

If you are going somewhere with medical care that you don't trust then I would cancel right now.

Going to France, staying about 30 mins away from a fairly large regional hospital.

Think I should to make a fuss and demand to see a consultant or something in the coming weeks?

I think you should demand a meeting with someone who can go through your scan with you and explain exactly what the risks are - and if that is a consultant, then yes.

Low lying placenta is different to placenta previa in that with PP it covers the cervix, with LL it is lying within about 3cm of the cervix.
Your sonographer didn't seem concerned as it's quite common and usually moves away as the womb expands.

That said, as it's now been diagnosed and you're aware make sure you declare it loud and clear to your travel insurance

Thanks zaalitje - where are you getting your definitions from? The NHS doesn’t seem to draw a distinction between the two, part from major, minor/partial.

Can you ask for the 29-32 week scan to be moved to just before you go?

I think you should be making a fuss and demanding access to the scan reports - they're your reports. The thing you need to know is how close the edge of the placenta is to the Os (the inside end of your cervix).

Placenta Previa and Low-lying placenta are the same thing. The placenta won't move, it's attached. But your womb will expand. Think of it like a balloon. You take a deflated balloon and put a pen mark really close to the opening. Then you blow it up. To start with, the top of the balloon expands and the pen mark doesn't "move" at all. Only when the balloon is nearly fully inflated does the portion of the balloon near the opening start to expand. Then the pen mark gets further from the opening. Your womb is the same - the bit at the bottom doesn't really grow until the 3rd timester so a placenta that's attached close to the cervix will be really close until then. Once the bottom part of the womb starts expanding, the placenta may end up further from the opening, and you'll be ok.

If your placenta is currently a cm or two away from the os, you'll probably be fine. If it's covering the os though, you may still have placenta previa at 36 weeks and you'll need a cs.

When the lower portion of your womb expands, the placenta may detach a little and you get bleeding. (the placenta is attached like a jellyfish, not a mushroom - lots of little attachments). The bleeding is bright red and there might be lots of it, potentially scary.

You may find your travel insurance won't cover you so there's no decision to make anyway.

I was LL till about 32 weeks. Sonographer always said if it moved more than 3cm away then they wouldn't be concerned.

9 out of 10 low lying placentas end up sufficiently out of the way to permit a vaginal delivery. However, if you have had a previous c-section, I think that statistic is slightly less favourable due to scar tissue from the previous operation. It is also less likely to 'move', I believe, if your placenta is anterior rather than posterior.

At 20 weeks, they can only diagnose a low lying placenta as everything is too squashed up and it is too early to tell where the placenta is going to end up further along.

The advice I was given when I was diagnosed with a low lying placenta was pretty much not to worry about it until I was scanned again at 32 weeks. To me, that means that you can go about your daily business, including going on holiday. But it may also mean that a doctor wouldn't sign you off to fly in the third trimester and that might be analogous to an over night ferry journey. In either case, medical assistance wouldn't be very easily available!

You are at slightly higher risk of bleeding with a low lying placenta. The risk goes up as you approach your due date. When I was scanned at 32 weeks, my placenta still totally covered the cervix. I didn't get a bleed, however, until week 36. At week 37 I had a massive bleed and the baby was delivered by emergency c-section 30 minutes later. Some people bleed earlier than that, some people never bleed at all and get to a planned c-section at 38/39 weeks.

I think that the above is pretty accurate - it's what I was told anyway. It's really about risk management. You are highly likely to have no problem at all, but I am personally very risk averse when it comes to these things! Even so, maybe talk to your midwife? If it was me, I'd probably still be going on holiday if I was feeling well and hadn't had a bleed up to that point.

Thanks all. I’ve phoned up and have gotten a consultant appointment for 3 weeks time, so I will be sure to get more details about it all then.

You'll need to ask your midwife or doctor for their recommendation. If you'll be near a hospital and have your notes I'm sure it will be fine.

I would be very wary of going on an overnight ferry if there is any risk.

If anything happens there is no medical help on an overnight ferry. I know this because DH is a hcp who has treated several patients on overnight ferries.

Good idea op! They'll help you make a good decision. Lorelai's description of it is good too - there's a really good chance it'll move out the way by the time you go. I'm thinking about getting a private scan before I fly just to stay informed (and will put my mind at ease if it's moved by then)