Placenta Praevia diagnosis - complaint against hospital

[Rara]

Sorry this is a bit long-winded! Was hoping for some advice?!
Dd is one year old TOMORROW - hoorah! We've had a great year but the pregnancy was crap - and made even crappier by my treatment following a diagnosis of grade 4 placenta praevia at 32 weeks.

I'll try to be short so you get the idea of what my complain is about: Was told I might have low-lying plac so was sent for extra scan at 32 weeks. BTW I had had no bleeding at all. Sonographer very brusque and she said "oh yes, it IS placenta praevia" I didn't know much about it at the time but remembered my midw had mentioned you had to have a c-section. Asked the sonog. this and she said "I'm not prepared to discuss you condition with you - that's for your consultant to do." She asked me when I was seeing him - this was Thurs afternoon- and I said the appointment was on Monday. She just nodded and made some notes so off we went.

After this me and dh went away for the weekend, did lots of walking, stayed in a fairly remote place, even had sex (!). Came back on the Sunday night and I read my notes. Did some investigating on the internet and started getting a bit scared about everything I read about plac. praev.

Rang my midwife and she told me to go to hosp immediately and an hour later I had a venflon in my hand , a steroid injection in my bum and was told I would have to stay the rest of the pregnancy in hospital as I could start bleeding at any time and it was a very serious condition. Anyway, had a miserable last 2 months, then had dd, everything with birth (c-section) went brilliantly and we were happy as larry.
However, speaking to the midwives on the antenatal ward before the birth, they were horrified that I hadn't been refrred to my consultant immediately after the scan, as the baby and I had been in danger, esp when you think what could have happened while dh and I were away that weekend.
Made a complaint to the hospital about 1)brusqueness of sonographer and 2)lack of immediate referral. Two months later had a meeting with the senior radiographer who said that the sonographer was entirely correct to do as she had done (apart from the being rude bit), i.e. not advise me that my condition was potentially life-threatening, because I wasn't bleeding at the time. They said they might consider changing their policy in future, and I would be informed and consulted.

Anyway, 9 months has now passed since that meeting and I've heard diddly squat. I've waited until now because the hospital was moving premises and I wanted the dust to settle there, plus I also got preoccupied with dd and it didn't seem as important. However, dh has been pressing me to get going on the complaint again and seek a satisfactory solution.

All I want, I've decided, is that the radiography dept. are more sympathetic in future and that they act appropriately if something like this is diagnosed during a scan, i.e. advise the woman to seek a consultation immediately. What if I'd missed my appointment on the Monday? What if I hadn't been curious and looked on the internet on the Sunday? I've drafted out a letter saying I hope they haven't forgotten me and I'll be taking the complain further if I don't hear anything very soon.
Do I have a case? Or should I just be grateful I didn't bleed and dd and me are OK?

Rara - well of course you should be grateful that you and dd are OK, and you are - not the point though is it? You have every right to feel annoyed. OK, the radiographer was possibly not qualified to comment on the treatment of placenta praevia, only to diagnose it, but I feel the scan department should have a policy of immediate referral to a consultant in such situations - esp. because you were 32 weeks pregnant at the time. I assume the classification of your placenta praevia was either Grade 3 or 4 due to the fact they kept you in hospital and because you ended up with a caesarean - such conditions should be treated seriously from the point of diagnosis. The least the scan dept could have done would be to give you some general information about the condition and warned you to take it easy until you saw the consultant. It is unfortunate that they were also brusque abd rude, which adds to your annoyance no doubt.
I am surprised that this is the policy of the scan dept at your hospital, and would think this needed addressing. I would be persistant and see that your questions are answered - good luck

Yes Leese it was a grade 4.
Thanks for your comments

Rara - thank God you and dd were ok. I have had grade 3/4 placenta praevia twice both resulting in abruptia and emergency c section - one at 32 wks , one at 29 wks. Both times I was warned the placenta was low at 20 weeks and scanned weekly from then. You must carry one with what you're doing , if only to help someone else. Good Luck - keep us informed.

Have you discussed this with your G.P.? We nearly lost dd because they insisted on me trying for a vaginal delivery even though I'd asked twice for a c-section, I just knew that things weren't going well. When I told my G.P. he was really sympathetic and actually suggested that I made a complaint. (What really annoyed me was that a woman on our ward asked for and got a c-section because she was 3 day's late and I was 2 week's!) I haven't made a complaint but I think I might now that I'm feeling stronger. I hope that your complaint goes well, it really does sound as though you do have a very good case to me.

HAPPY BIRTHDAY RARA'S DD!

Rara, I can really sympathise and wish that I had been strong enough to complain about my treatment when I suffered placenta praevia. With both DS1 and DS2 I had bleeding from 6 to 18 weeks and with DS1 I was told that this was due to a low placenta (which eventually cleared itself). At the 20 week scan with DS2 I wasn't told of any problems and it wasn't until I started bleeding at 30 weeks that I began to suspect otherwise. I had one night in hospital and the bleeding stopped so I was sent home - no scan, no consultation. The following day I bled again - back to hospital, the bleeding stopped and there were rumours that I might be having a scan but the staff didn't seem to know. Then the heavens opened and the blood just gushed so I was rushed to delivery suite. This was 11am and although I continued to bleed and eventually started to go into shock, the consultant didn't visit me and decide to do a section until 5pm. They stuck the steroid injection in then shaved me and took me to theatre and I was near hysterical at this time because I didn't want a general. Still nobody had actually told me that I had placenta praevia. DS2 was rushed straight to SCBU, and ventilated as he was only 31 weeks. I didn't get to see him for 18 hours because I was receiving blood transfusions and they didn't even take a photo of him for me. After the event midwives kept mentioning my placenta praevia (grade 2 or 3 I think) as if I knew all about it and I just got more and more cross and upset because I had been in a life threatening situation and was just fortunate that I was actually in hospital when the worst happened.

I'm sorry to hijack your thread Rara but 6 years on I still feel very bitter about the whole episode and wish I had asked for more answers at the time. The good news is that DS2 came out of hospital 3 weeks later apparently unharmed by his early arrival and I had DD by VBAC 3 years later.

Incidently, I think that having a follow up scan at 32 weeks is too late, lots of women with PP start to bleed before then and it would be better to know sooner rather than later if extra care had to be taken, eg. no sex, no lifting etc.

Pam, this is awful. No wonder you feel bitter.

I agree with everything the others have said. Take it further, for the sake of those who come after you, as well as your own peace of mind. I had a low placenta with DS2 from 20 weeks, which corrected itself by 32, but they were very casual about it.
I also had a brusque sonographer when my first miscarriage was diagnosed, but that's for another thread. I think something should be done about the sensitivity, or otherwise, of sonographers. If they can't be bothered to train them in patient care, then a nurse should sit in so that she/he can deal with the couple in the event of bad/scary news.
Hope it goes well for you.

This would not have happened at our unit. Women who are referred for scans because of a suspected problem, have an appointment with the obstetrician straight after to discuss the results of the scan. This definately deserves to be investigated. No woman diagnosed with grade 4 placenta praevia should leave the hospital without seeing a consultant. IME women are not allowed home at all. Keep going till you get answers.

I also agree with what others have said, Rara. As Mears has confirmed, anyone with this sort of diagnosis should have been assessed and probably admitted. I had a good friend with PP grade 4 and she was monitored continuously from 20 weeks and in hospital from 28 onwards. Like you, she and the baby were fine in the end but things could have turned out differently for you, and you are absolutely right to continue your quest for answers.
Sorry to hear about your negative experience with sonographers. Mine has always been ultra-positive, they are a really nice team at my local hospital. And much gentler on the tum than doctors let loose with an ultrasound machine...IME.

If you still aren't getting anywhere try going to www.nhs.uk and head for the complaints section, at least then you will know what your rights are! Also your hospital should have a copy of their complaints procedure available for you to look at. If your hospital has a Patient Advisory Liaison Service (PALS) they're usually really helpful. Good luck!