Posterior Placenta Previa - need experiences

[Ema91]

had my 20 weeks scan two weeks ago, which reveales I have a posterior placenta previa (8 mm covering the cervix).

My midwives said there is good hope that it will move up, but in the meantime they referred me to the hospital midwives to have more checks in between and to better monitor me.
Today I had my first appointment at the hospital and the midwife didn’t check my placenta, she told me they will only measure it by 32 weeks, so in the meantime they would only make an external ultrasound to check the baby etc.

Based on the info , she told me that since it is posterior, she does not expect that it will move up, so I will likely need a c section. On the opposite, anterior have higher chances to move.

I feel sad and frustrated. I am afraid of bleeding, I am disappointed i will not be enjoying this pregnancy as I was expecting to and I feel confused by the contradicting info I get from my midwives, on the web etc.

I also feel bad about having a c-section.

Anybody with a posterior previa that moved?

I also have posterior placenta previa, although not as much as yours. I’m 27 weeks now and at a recent scan my placenta had only moved up a very tiny amount and nowhere near enough to be able to have a vaginal birth. They will check again but I had a consultant review who said it’s unlikely to move now because at this stage the stretching all happens at the front so if it was anterior PP they’d be more hopeful of it moving.

Don’t feel bad about having a c-section. It really is the safest option for you and baby with PP. As the consultant said to me - you can’t physically push a baby out through the placenta.

I understand the feelings of sadness and frustration. It has really taken its toll on me as I’ve had multiple hospital admissions due to bleeding and had to stop working already. It’s also left me concerned for any future pregnancies as they say it’s more likely to happen again.

But it’s great they’re keeping a close eye on you and the baby with extra scans and appointments. It’s such a worry.

What is the entity of your previa?
Being a researcher, I’ve been searching for papers to understand the theory between the difference observed in anterior vs posterior placenta moves.. and it is pretty inconsistent. Of the four studies I read, 2 were claiming that anterior will shift faster than posterior, 1 concluded that posterior will shift faster than anterior and 1 claimed that there was no statistical difference.
In one of the studies, of those women who had a marginal previa covering the OS, 67% resolved by 32 weeks.

You have time though, my midwife told me that they usually check the placenta at 32 weeks because that’s the moment where the placenta could have traveled at the maximum distance.

It’s hard not to be disappointed if it does not move. I know it’s the best way to deliver the baby… but it just feels so unfair that I can’t have a “normal” delivery cause I get these complications.

Another very serious concern I have is that i read that of those women who had a c section due to previa, the risk pf placenta accreta and hysterectomy in their second pregnancy is higher..

There is a higher risk of placenta acreta if you have already had a c section. I had PP twice, second time the placenta completely covered the scar, but mine was fine. I was involved in a study to see if ultrasound or MRI was better at detecting Placenta acreta. It was based at Queen Charlotte’s in London in 2010 if that helps you to find the results.

My placenta was posterior and identified as probably covering my cervix at my 20 week scan, but they couldn't see it so don't know where it actually was. I didn't have any bleeding.

It didn't move (or at least not enough) so I had a section at 37 weeks. The section went very smoothly and I lost very little blood, easy recovery and no ill effects for me or baby.

When I was initially told that I had to have a section I was very upset, but that feeling didn't last long (and definitely gone by the time baby was born). In retrospect I had one of the better births out of my friends.

I'm currently pregnant with number 2. Only 7 weeks though, so don't know where my placenta is yet. From what I understand there is an increased risk of placenta acreta, but that risk is relatively small and will be monitored.

Hey!
I’m currently 29+2, and like you they discovered my placenta was covering the os at my 20 week scan. Covering by 1.7cm, also posterior.

I had similar feelings to you back then, disappointment that I might not be able to have a vaginal birth. My consultant set expectation that mine probably won’t move enough by 32 weeks (suspect that’s due to how much it was covering). I was told no penetrative sex, and the consultant not willing to give me a fit to fly beyond 28 weeks (I was also told any travel before 28 weeks was at my own risk - but I only got told this at 26 weeks when I’d already done 10 flights in Jan, inc. long haul!)

I missed out on a planned weekend away with friends last weekend due to not being able to fly, but I’ve not had any bleeding so far, which I’m really thankful about.
I’ve very much come to terms with the fact that it may be a c-section delivery, and that’s totally ok if it’s the safest way for both me and baby. That took a little while to get my head around though.

I have another scan/consultation at 32 weeks, feel a little bit in limbo till then as it can quite dramatically change due date/may leave date so very much looking forward to knowing the outcome!

Good luck with your next scan! Tell me how it goes!!
and so happy to hear you didn’t experience bleeding! I think it is a good choice to rest as much as possible. I am doing the same despite my midwife didn’t tell me to change lifestyle…

I had placenta previa at 20 weeks. I think it was anterior but it was fully over the cervix with no gap. I know what you mean about worrying about bleeding- I even had a bit of bleeding at 27 weeks but the hospital said it wasn’t enough to be worried about! That confused me and made me more anxious. Luckily by 31 weeks it had moved enough. However I then developed preeclampsia and had a csection in the end at 35 weeks for the safety of the baby. My csection classed as an emergency but it was like an elective compared to the people who go through long labour and end up with a csection after that.

I hope it moves for you.

I amhappy things turned fine for you! I am pretty positive everything go well in the end, i just think i need to cope with it and I hate the idea that i will have to live these months with a but of anxiety and always on the lookout for some bad surprises

Hey!

Following up for info: I had my 32 week scan this morning. My placenta has moved but not far enough. It was covering the os by 1.7cm at 20 weeks, and is now 1.5cm clear of the os. They need it to be 2.5cm clear of the os.

I have another scan 2 weeks on Weds (at 34+3) to check again, but the consultant set expectations that it probably won’t have moved enough by then so is likely to be a c-section at 36-37 weeks.
Same precautions to follow in the meantime: no sexual intercourse, no strenuous work, any sign of bleeding go to hospital.

Hey! I am positive for you! Still a month to go after your 32 weeks scan and I have heard that many got cleared for vaginal delivery at 36 weeks. And so far it seems it moved a lot!! Wow, that’s almost 3 cm shift…
Good that they are still monitoring how it is moving.
Let me know how it goes. I won’t have mine checked until mid April so still a long way…

Update: had a scan this morning (25+4 weeks).. they did not measure the placenta but could see that one portion is still on top of the cervix…
i hoped it had moved since at 20 weeks it was only 8 mm over it…they will measure it at 32! Fingers crossed!

I had posterior placenta previa at 20 weeks. I had a lot of issues with bleeds etc which stopped around 27 weeks. 28 week growth scan showed it had moved enough, 32 week scan showed moved even more! By time I gave birth the leading edge was around the babies neck so a whole head away! I did spend a lot of the early pregnancy in hospital, and no babymoon abroad for me but caused zero issues with delivery or babies size (over 9lb!) Which was a concern due to the bleeds. Look at it this way, even if it doesn't move it's at the back so it's not in the way of the c section!

Thanks for your kind words of encouragement.
i feel actually a bit hopeless and a bit disappointed because:

1. Between 19 and 25 it hasn’t moved.

And 2. They told me that if it does not solve at 32 weeks, they will schedule the surgery and will NOT look at it anymore because there is no chance for them that it will solve.. even if it has improved. We are talking about 8 mm over the cervix.. not complete previa!

To me this is really stupid. I have heard so many stories of women who got checked after 32 and got cleared for vaginal delivery.
i don’t understand why they should put me at an increased risk to develop the same situation at my second pregnancy (it has been found that women who had a c section are likely to develop previa at their second pregnancy - and increased risk of accreta). Of course these are “bad scenarios “ but could certainly help to have an extra check between 32 weeks and the c section day.

I had a scan at 22 weeks and the distance was no different to 20 weeks but by 28 weeks it was over 40mm clear. It can move a lot in the middle stages. I ended up with a category 1 c section anyway after failed forceps delivery. Even if it does move, things happen. But I fully dilated so apparently my chances of a successful VBAC are over 90%. Lots of people have subsequent children after a c section, while risks are increased, the risk is still really small.

To attempt a vaginal delivery, the placenta leading edge needs to be at least 20mm away from the cervix. Any closer puts baby and you at huge risk. If it's borderline I'm sure you could ask for another check, but if it's still on the cervix the chance of it moving far enough is virtually non-existant. I was told if it's not moved the C section is done at 37 weeks as they can't risk you going into labour naturally, its exceptionally risky. Because of my bleeding I was told I'd have to be admitted to hospital at 32 weeks and to expect to deliver any time. A friend had complete previa for both her pregnancies and delivered both at 34 weeks. The risk of a severe haemorrhage is greatest after 32 weeks.

I get it's disappointing, I cried over it! But honestly the C section was absolutely fine and getting baby out with you and baby healthy as possible is priority.

So you delivered at 32 weeks because of a bleed? Even though your placenta had moved 40 mm by 27 weeks?

well, i am the first one who wants a c section if the placenta is on the way.
what I don’t like is that they won’t check my placenta position anymore between 32 weeks and 37 if at 32 it is still close to the cervix…

Mine is low lying posterior (within 2cm of cervix). I had a growth scan at 28 weeks and it had moved a little bit but not enough to be out of the danger range. 32 week scan is next week and I'm really hoping it's moved 🙏🏻

Following up again… had a scan yesterday at 34+3. My placenta is now 2.3cm away so I’m back to being low risk and have no need for an early c-section.

Also back to midwife led care and hopefully a water birth 😊

I was fully expecting it to have not moved enough but it’s shifted 0.8cm in 2 and a bit weeks so don’t loose hope if yours isn’t quite out of the way at 32 weeks!

Omg that’s the best news! I am so happy for you and you give me a lot of hope!!
yours was 1.7 cm over the cervix right? Mine was 0.8 cm at the 20 weeks scan… they did not measure it anymore but from an external ultrasound they could still see that at 25 weeks it was still over it.
i really hope that something is happening in these 7 weeks , but a shift of approx 3.5 cm to be cleared seems a lot….
and I hope I can convince them to measure it again after 32 weeks if it hasn’t moved enough…
last time i was disappointed to hear from them that 32 is the last scan and they won’t check it again if it hasn’t moved and we will schedule the surgery…..

Thankyou! I had fully come round to the idea of a c-section delivery and thought I’d be a bit disappointed about waiting another 4-6 weeks to meet baby, but I’m really happy that I get to go through the full pregnancy experience!

Yes correct. My measurements:
1.7cm over at 20 weeks
1.5cm away at 32+1 weeks
2.3cm away at 34+3 weeks

I’m sure it’s hospital/consultant dependant but I did feel that they wanted to try avoid c-section if they could, hence the additional scan at 34+3.
Really hope you have the same experience!

n.b. I thought it needed to be 2.5cm away but it’s only 2cm.

We had our scan on Tuesday and mine is now 3cm away (moved about 1.5cm since 20 weeks so slow going for me). Weirdly everyone is still being cautious about it and the sonographer still wanted to call it low lying. I thought I was in the clear now 😂

Newest problem is that baby is breech 🙄

Yes i believe every hospital has their own rule on how much it should be away, i will double check this.. but thank you so much, I have hope again now :)
i will keep you posted. My 32 week scan is on the 29 April.
i have another quick check beginning of April but only qualitative

Well with the placenta being 3 cm away you should def be ok!
breech babies can still turn I think..
i mean, you still have a couple of months :)

Keeping everything crossed for you! Don’t be too disheartened if it hasn’t moved much at the start of April.
I think my bump has definitely grown more in the last few weeks which I’m assuming has caused the placenta to shift, might be the case for you too…

@Ema91 Yep, fingers crossed! I have until 36 weeks before they send me to the breech clinic so 3.5 weeks for my little one to point in the right direction 😂

Sooo… today I had my 32 weeks scan to check the placenta location and… sadly it is still there… didn’t move much and still around 5 mm over the cervix.
they will check again at 36 weeks but I think chances are slim for me..afterall it didn’t move in 3 months.