Urgently need info and advice on Placenta Praevia

[Rhubarb]

For someone who cannot access Mumsnet.

She is 35 weeks pregnant and has the above condition. She was told rather abruptly by her consultant that she may haemorrhage and then bleed to death. This consultant wants to to change to a different consultant as he wants to pass the responsibility onto someone else.

The earliest date they have offered her for a section is the 6th of February. She could book herself into hospital until then, but she has 2 small children at home and no-one to look after them for her.

She is suffering from ante-natal depression because of the stress and the consultants and hospital are being extremely unhelpful and unsympathetic. They've basically told a pregnant mum that she'll probably haemorrage at home and bleed to death.

Any advice would be very very gratefully received and we'll make sure she gets the advice asap.

hey rhubs

for a start heamorrhage and bleeding to death is a risk with placenta previa grade 3 and 4 IF a vaginal delivery is attempted or prem labour ensues. grades 1 and 2 do not present the same risk factor.

does she know what grade her PP is?

c.s usually offered 38 weeks to try to avoid labour starting naturally. sometimes bedrest in hospital for very severe cases

www.aims.org.uk very useful re rights and care during pregnancy and birth

yes , bleeding and heamorrhage might be a risk but it needs to be told in such a way the mother understands the risk, and the possibilities of it happening and not being left scared to death

reading between the lines , she might have grade 3 or 4 and should be in hospital if possible.... does she have friends or family who could help?

Thanks lulumama, yes you're right she's a grade 3 or 4 and ideally she should be in hospital as this is her 5th pregnancy, so although prem labour may not happen, it's still a risk.

However she is a single mum to 2 young children and doesn't really have family to help out.

And of course she's frightened to death.

bump

sorry rhubs, wish i could offer more help

it would be interesting to see the difference she feels about her condition with some respectful and kind care

Thanks lulu, a bit of tlc certainly wouldn't go amiss here, but I get the impression she's being made to feel like a nuisance.

Think I might also pop this in childbirth.

Hi Rhubarb

I had this (grade 4) when I had dd1 and was in hospital from 27 weeks until 36 weeks when I had an elective section. I also got fed the line that I might bleed to death, but this was to stop me stropping (!?) and trying to discharge myself. Result: dh was scared stiff and he forced me to stay put!

Has your friend had a bleed already? If she hasn't bled then I think she's considered less 'at risk' than someone who has had bleeding already. (I bled heavily at 27 weeks which is how I found out I had it and why I ended up in hospital.)

Whereabouts in the UK is she? I had a wonderful consultant at the Royal Berks in Reading, who was very 'straight' with me about the risks, but also didn't try to scare me to death. (The 'bleed to death' comment was from one of the other - very helpful - doctors.)

I would be quite worried if I were in her position. Sorry - I wish I could be reassuring, but I hope you'll be able to put this to her in as unthreatening a way as possible. When I was hospitalised (and when I was stropping and trying to go home) I lived approx. 5 mins drive from the hospital, and they still wouldn't let me out. They said that if I bled suddenly my baby would need to be born within 10 minutes to save both our lives. They were taking blood from me to cross-match and save twice a week in case I lost a lot of blood and needed a transfusion. I was also given steroids to mature my baby's lungs (though this was when I was admitted at 27 weeks and I think they stopped them at about 34 or 35 weeks, so your friend is probably past the danger-point for that now).

I think that your friend needs to ask for a second opinion and to try to find a more sympathetic consultant (at a different hospital if necessary/feasible). I can see that it's hard for her to hospitalise herself if she has two other children to look after, and I am not a doctor, so I can't say whether it's really necessary for her to be in hospital or not. However, I think she should consider it, at least; preferably with expert advice. Presumably she has someone lined up to look after the other children when she has her c-section, and it may be that she has to call in that help earlier than expected.

Sending very best wishes to your friend. I hope she's fine and has a lovely calm section with a happy outcome.

Not sure what to say but had an incredibly similar experience (to the extent that I'm now wondering if it was the same fxxxxing consultant).

I was also offered instant hospital admission - though discouraged from taking it. (Despite living a long way from the hospital). A real case of covering their backs I thought. I remember being utterly terrified. Good advice from lulumama I think. First of all she needs more information - seeing that alternative consultant may not be such a bad idea. I'd suggest getting the consultant to draw an illustration of exactly where they think the placenta is located.

When I saw a rather more understanding consultant he was really positive and reassuring about having made it to 35 weeks without bleeding. Has she had problems or was this all picked up from ultrasound?

okey doke. i hope she gets proper information and care and is not made to feel bad

pp is a real issue and needs careful management...she needs to be cared for, not made to feel like a waste of time

sounds awful. I had pp in pg with ds1, very worrying. ideally she should prob be under observation from around now - does she have any family or friends at all who could look after dc? From experience of a very bad hosp which also caused me to get and/pnd/ptsd (was so awful that they couldnt decide what sort of depression i had in the end - but who needs labels when you are down a black hole?) I moved to different hosp. I got to the point of telling DH I would rather die at home than be admitted to that hell-hole, they just terrified me with everything they said and once you are feeling like that, every little thing they add just piles up.
Do some research, on here or wherever and find out what other hosp is good - my faith has been put back by the absolutely wonderful care i was given having DD (no3).
I know that this lot may not help regarding the technicalities of P.P, but may be of some use in the situation as a whole IYSWIM

Good luck to you and friend

Thanks for all your advice. She's in Oldham and doesn't live near the hospital.

I don't honestly know if she's had a bleed already. But all these messages will be passed to her and hopefully these will help to make a decision that she's happy with.

My sister knows her much better than I do and I'll send her a link to this thread so she can offer further info too.

not pp related but AND related - at my hospital having AND/OCD meant I was referred to the disability support midwife - so as well as being able to arrange separate appts with her, I was able to phone her up with PG related queries - I wonder if this lady's hospital has a similar arrangment - as then there might be somebody nice and supportive she could talk the medical issues issues through with?

surely there's something better in the manchester area??? really hope so. Please keep us posted on how this all goes.

Good luck to her Rhubs. Tell her to insist on talking to as many people as possible until she gets a reply she's happy with. (I do understand that may not be easy if she is depressed. I wonder if she has anyone who can go with her as an advocate?)

I discovered I had PP with DS one at 30 when I woke up bleeding - had a shock that day as hospital told me I was likely to have to stay in and would defo need a c section. I only stayed in a few days that time though - glad I did as that night had a really heavy bleed and was rushed up to delivery but luckily bleeding stopped.

I made it through to my 38 wk c section with one more major bleed and some smaller ones. Each time hopital threatened to keep me in but my consultant was happy for me to go so long as I took it easy.

Basically, I think if you haven't bled then chances are better but they told me not to go more than 15 mins from hospital as if bleeding didn't stop one time then it would be serious. Also said I wasn't to push heavy shopping trolley round etc.

Was a scary time especcially when going to the loo and blood pooring out but as long as you call 999 and can get in quick should be ok.

She really needs to have urgent help to call on for kids - a big bleed is no joke.

could she be referred to st mary's hospital if she is not being seen there?

hi this is the lady in question with the placenta previa

Firstly i would like to thank rhubarb for posting the question, til i finally worked out how to use this site, oops, and thanks to every for their kind words support and advice cried whilst reading all the messages, hormones !!!

The low lying placenta was picked up on a scan early on. Its a major placenta previa and wedged in covering the os section is only option. Had big bleed like ellbell at 27 wk, steriods given for baby lungs.hosp a week no further bleeding.

My consultant says i am putting him under pressure by asking for an early section and makes me cry each time i c him, wrote death in my notes and underlined it, advised me i would bleed to death within 15 min if at home. He thinks my 17 year old should be looking after my 3 and 4 year old. I want an early section so i live to treasure all of my children, am 34 wk she measuring 36 wk and weighs 6 pound.He refuses til 8th feb cos the baby has to be his only concearn. Like gigglewitch i am now depressed cant sleep and planning events in case i dont
survive.

Thanks again for all your support xxxx

emmiebb... I am really sorry to read this. It seems to me that your consultant is being doubly unfair. On the one hand, he is threatening you with dire consequences if you stay at home, but on the other he won't agree to an early section. I'm so sorry that you are being pushed around like this. He sounds like a complete egomaniac. I think you need to ask to see another consultant - in a different hospital if necessary (or if possible). Is there someone you can take with you who will stick up for you and not let you get pushed around? I know it's hard when you're petrified and hormonal and depressed, but you need to stick to your guns on this. I had my section at 36 weeks because they weren't convinced my placenta would hang on any longer. I was told it was 'hanging by a thread' (nice image... not!) and I had already lost a bit of it during one of my bleeds (though they only realised that later when they took the placenta out after dd was born and had a look at it... gross!). There are pros and cons with an earlier c-section. My baby was small (4lb 12oz - and I wouldn't trust the estimate that yours is 6lb now - they are notoriously unreliable... I was told my dd was about 5lbs about 2 weeks before she was born!) and needed tube feeding for a couple of weeks and I never managed to establish breastfeeding, which I was very sad about. On the other hand, she and I were both safe and she is now a lunatic 7-year-old that will talk to you till your ears fall off and never sits still ! You need proper advice, and you're not getting it from your current consultant. When all this is over, I hope you write to the hospital and complain about him. I am really angry on your behalf that you've been treated like this.

Take care, and good luck.

ellbell... thank you so much for your kind words, u are right he is an utter egomaniac. He looks down on me cos i am a single mom not completly my fault tho and cant be helped couldnt have gone through the easier option of a termination. my last baby was born at 35 wks weighing 7 11 and previous was 9 11 at 38 wk am sooooo scared of starting labour on my own at 35 weeks because that is when the palcenta will heromage. after your advice i am thinking of ringing another hospital tomorrow. Although it is an awful thing to go through it helps so very much knowing that some one else has gone through it and both mom and baby survived x

Please ring another hospital, emmie. Explain your situation (single mum, depressed, scared) and say that you are very worried and really need the chance to talk through your options. It may be that they can't give you a consultant's appointment straight away, but you may be able to talk to a midwifery sister or someone else who'll be able to help. Don't be afraid to lay it on a bit thick if necessary - I mean, don't feel you have to put a brave face on... just tell them how you are feeling. Meanwhile, stay as calm as you can. Keep the phone near you at all times, and ring 999 if you are at all worried. You will be fine. I wish I was nearer to you (and didn't have to be in work tomorrow) or I'd offer to come with you and hold your hand! Take care, and please don't forget to come back and tell us afterwards what happened. I will be sending you positive vibes...

Hi Emmiebb,

So sorry to hear that you are being treated this way. The NHS offer an independent and impartial advocacy service to help you complain if you feel you have been mistreated, and to support you through any treatment you are having. I am sorry but I don't have details of how to contact this service, but I am sure your local GP surgery or hospital will have details.

If your depression or stress is affecting your ability to deal with things you could contact a local charity such as MIND to see if they could help you by providing an advocate to help you; I don't know about in the Manchester area but where I am there are a couple of women's charities such as Womankind, who may also be able to point you in the right direction for support.

I hope all goes well for you, keep us updated...

Emmiebb - any progress? Somebody needs to take responsiblity to see that you can form a proper and workable range of action plans. Totally unsatisfactory imo that this hasn't happened. I'm so sorry that you're in this state of fear - I remember feeling like a human time-bomb and being utterly terrified. This is not a mental state in which you can reasonably or realistically be expected to work things alone. I'm sure with a sensitively handled consultation and a clear plan of what to do when, you will feel much calmer.
Ellbell's post says it all really - keep in touch.

Hi just quick update.... rung another local hospital today but as i am 34 wk and due in hosp 2 wk today for my section they advised me to stay put as i would need a referral from my gp which surprise surprise would take about 2 weeks !!! Decided to go and talk to my local mid wife who was very sypathetic and she said although my consultant looks after his ladies he a bit of a stickler and set in his ways. It was left in her capable it of hands and she advised she would get back in touch thursday with, hopefully a new appointment with a different consultant who might show a bit of empathy for my situation. Can i just say how truly grateful i am 2 all of youfor all your help and advise and would probably be still down my black hole if it wasnt for all your support, thank you xx