Major placenta previa

[rek21]

Well, I've been burying my head in the sand about this so far, but I think now is the time to ask for the collected mumsnet wisdom.

At my 20 week scan the baby's placenta was centrally positioned at the bottom of the womb completely covering the os. A repeat scan at 24 weeks showed no change of position although the sonographer felt that there was no sign of the placenta growing into the scar from my previous c-section (DD, 16 months was breech). I have another scan lined up at 29 weeks followed by a consultant's appointment.

I'd really like to hear from anyone with experience of this severity of the condition, either first hand or otherwise. Is there any chance of the placenta moving? I have found it hard to pin medical types down on this - the best chance I have been given is 50/50. Has anyone had major placenta previa and not had a bleed? If so when did you have a c-section? Do any other symptoms accompany bleeding? I have this fear that it will happen in the middle of the night and I won't even realise!

Really, I'd be grateful for any experience. I have read the RCOG guidance on the net but I would really like a more personal perspective.

Many thanks.

My dear Rek, I think you have been patient long enough. Probably those in this thread who know what they are talking about will say that you should wait and do as the professionals tell you but it surely has to be about balance - the baby's health measured against your all-round well-being. You need to be well & happy, not exhausted & traumatised, when the baby arrives. The rest of your family need huge consideration too - yr dd must wonder what's happening & it must be hard on yr dh to see you in pain & upset. Has not the time come to say "Why am I actually having to wait any longer?" I guess the baby is considered to be a good weight/viable now & you will have had enough time to mentally prepare yourself (and more, by the sounds of it!)This is only my amateurish suggestion but, I know if it were Kerry in your shoes, I would say she should at least set the ball rolling for an early delivery; they can only say no. Tell them you wouldn't dream of insisting on delivery BEFORE Bank holiday but immediately after would be acceptable! And for what it's worth, no, you are not bonkers. If I read your story correctly, you've been in there for 9 weeks or more and the inevitable is ever closer. If they can give you 4 good reasons to wait, so be it, but you have 4 good reasons to have it over and done with, and that babe in your arms. Am I very wrong girls?
Good luck, Rek.

Love Glynis xxxx

Oh Rek, it sounds grim.

They scheduled my cs for 34+2 weeks (I didn't make it that far). Their reason was that they didn't want to do an emergency cs. I had placenta percreta - high risk of massive blood loss - I had a 16-pint transfusion in the end.

But they thought that 34 weeks was a good compromise between "too soon for the baby" and "too late for the mum". Although actually they wanted to do 35 weeks, but that was Christmas Day! And they didn't want me to be pg (and risky) over Christmas when there are less staff on.

36+3 is pretty good. You need to ask to talk to a paed from NICU about the likely differences between 36+3 and 37+3. They see so many babies born at those gestations, they should be able to give you an idea. If they say there is a big difference, that will help you have the strength to cope with the week. But they might say, not much difference. I don't know, mine didn't get that far!

Also ask the docs what effect the internal bleeding might be having on your baby. Talk to the docs anyway, they need to know what you are feeling.

Oh Glynis, you've read my mind! I hate the way this is affecting the rest of the family, particularly dd and dh but also my parents and mil who are working so hard to help us. I have to confess I've only been here 5.5 weeks, but it will be 8 by the time the section comes. The next 2.5 weeks seem an impossibly long time. I'm glad that what I'm saying doesn't sound completely doolally. I will see what the consultant says about moving the section. The mdwife did not sound hopefull though. Thanks again, it's good to hear from you, rek x

Sorry fruitful, I cross-posted there. What you say about talking to the paediatrician makes an awful lot of sense. Part of what I am finding so frustrating now is that in an effort to encourage me all the docs, m/wives etc keep talking about what a good gestation she is, how well she will do etc. All it makes me think is 'why can't I have her now then?'! And then again with the guilt for thinking that ...

It sounds like you went through the mill physically too with transfusion etc, again something I want to avoid, along with ga, which seems more likely if the section is planned, rather than in response to a big bleed. Grrr.

Anyway thanks for listening to my whinging, and for reminding me that there is light at the end of the tunnel. Hope you and all family are well, rek x

Hi Rek...

You poor love... You are really going through it aren't you. Getting to where you have is such an amazing acheivement!!!

You are well within your rights to feel like you want baby out now. I remember feeling like that at 29 weeks!!! (horrible thoughts go through my mind in horrible situations!)
What have the docs said?? Is their plan still the same. I'm actually quite shocked that they let you go through 36 hours of contractions!!! Did they monitor any of it??? (obviously they cant do an internal exam) seems like you body is saying its ready now. Never feel guilty for feeling the way you do Rek... Its completely normal for human beings to want to get out of a bad siutation. You are not in control of it either which makes everything so much worse.

I would push and push for an early delivery its important as Mumnorfolk says to be in a good mental state and also for your DD to be able to be close to you. (and of course DH) LOL

Fruitful is right too you need to tell them what you are feeling its really important that you can ask lots of questions and also that your given the answers in full and not just a quick 'its all going to be fine' (I seemed to get that quite a bit when I asked questions).
Glynis you are not wrong my love!! x

36+3 is very very good Rek keep strong and focused love to your DH and DD

As always my thoughts are with you too
xxxxxxxxxxxxxx

morning

Im new to this website & would appreciate any advice/stories on placenta previa grade 4. I had this with my daughter in sept & it was a very scarey & traumatic time but all good & my daughter is now 7 1/2 months. After months of saying never ever ever again, we have now decided to look into having another baby. We have seeked medical advice on my having this condition again, & we have been told that the chances are very very high, this is now scaring me now as i was in hospital for 40 days last time & i dont know how i coped the first time & dont think i could do that stay again with a little one at home. Has anyone gone on to have a 2nd baby after having grade 4? Was it as bad? I know all pregnanices are different but would like to hear any stories as im finding it hard to deal with thinking i wont have any more children.

Thanks

Rachel

Rek - Hi I've been following your thread for a while but haven't posted as everyone else is already given you lots of great advice/support (better than i could )

Glad to hear you've made it to 35+ weeks. I had gd4 pp with ds1 and had to be in hospital from 34 weeks onwards. I was 'lucky' in that i only had 2 bleeds, my first bleed at 36 weeks so had none of this bleeding on and off/contractions/etc stress and worry that you have. Ds1 was born at 36+6 when i had my second bleed which ended up in a crash section and quite a lot of blood loss. He was perfectly fine and was able to stay with me. However, ds2 was born at 35+2 and had to stay in SCBU for a week (nothing to do with pp this time).The girl in the bed next to me on the antenatal ward also had pp and had her dd at 36wks. However even though she was older her dd was in an incubator next to my ds who was well enough to be in a cot. Obviously all babies are different but i think around the 35/36 week stage there is a fine line between whether a baby will need to be in special care and how much care they will need.

Having being stuck in hospital with pp (admittedly not as long as you) and having had a baby in SCBU I personally found the SCBU far more upsetting and stressful. I can totally understand you wanting to bring the c/s forward, but if you can just hang on for a few more days it could make such a difference.

Having said all that, the consultants will untimately make a decision on what is best for both of you, and honestly i know it probably feels never ending right now, but you are so, so close to the end.

raqfletch - it might be worthwhile starting your own thread on this.

We also said never again after i had ds1, (think dh was even more traumatised than me!) and it took us a bit longer to come round to the idea of another one.

We asked about the risk of re-occurance and were told it was something like 10% chance, so alot higher than average, but certainly not very very high. So we went for it.

At the scans the first thing we asked after 'is the baby ok' was 'where's the placenta'. In our case it was perfectly fine. I found the worst thing was waiting to find out where it was. As it happened i ended up in hospital for totally different complications but 2nd time round it's less stressful. For a start, you've already been there/done it. Dh took some time off work, and then my parents came to stay and look after ds1. There were a few people on the AN ward with me who did have pp and were having their second. Our older dc's came to visit every day and it was obvious an assortment of dh's, and grandparents, aunts and uncles were helping look after the older dc's.

We are now considering dc3 and even though we are aware the chances of me ending up in hospital are quite high we are still going for it.

One thing i did find helpful was getting hold of my hospital notes. It helped fill in some of the blanks.

Hello everyone,

Well I saw the consultants today and they were not keen on the idea of moving the section. As fruitful suggested a paediatrician came to see me and it seems that the chance of respiratory distress are measurably less at 37 weeks than 36, although as Dontlook says it is a bit of a grey area and depends a lot onthe individual child. I think I'm prepared to accept that 37+3 is better and tough it out till then. Things have been helped a lot by baby rek shifting position so she is no longer putting pressure on my back, so I'm in a lot less pain today and could pick up and play with dd a lot more freely.

raqfletch I have actually been told that the risks of this happening again are low because the placenta can only implant in the same place once, in other words your classic pp case is more likely to be a woman with 5,6,7 children, although of course the section ups the risk. However I know how you feel, I have always wanted a big family, but now I just can't imagine risking going through all this again. Even if there was no pp the idea of a 3rd section (as would be v likely) is quite horrible. On the other hand, with only 1 section you would have a good chance of a vbac I should think. My dh reckons I'll have forgotten all about it and be ready to start again in 6 months but I very much doubt it! Good luck with whatever you decide.

Lots of love to all, rek.

Hi Rek,

Have been reading this thread with interest. I've just come out of hospital following a second bleed. I'm just 32 weeks and my previous bleed was at 27 weeks.

Today the consultant told me that if I bleed again I'll have to stay in until the babies (it's twins) are born, or if at the next scan in two weeks the plancenta is completely covering the cervix, then I'll have to stay in from 34 weeks.

The consultant wants to do a c-section at 38 weeks, which to me seems really late. I'm thinking about changing hospitals as I know that at other London hospitals the time frame for c-section varies.

Sounds like you've had a really hard time. But it's inspiring to know that there are people out there in very similar situations

Hi happymango, sorry that you are going through this rubbish situation too, but it is good news that they have let you go home. The paediatrician I spoke to today said that NIHCE guidlines state that the c-section shouldn't be done until 39 weeks so I suppose I should think myself lucky! I don't know what the deal is with twins, but from what I have observed on the ward in the last few weeks 37 weeks seems to be the most common delivery time for twins with no complications. I'm not in London though. Hope it all goes well for you do post and update me! I really hope you get as long at home as possible, but do take the advice to stay in hosp if it is given. For all my whinging, after 2 big scary bleeds I wouldn't want to be more than 2mins from a blood transfusion! Take care, rek x

Rek I'm so sorry you're going through this. It does wear you down in the end doesn't it - the endless bleeds, the fear of the unknown, the awfulness of living every day in hospital in a state of high alert and panic. I just found it so hard - I never knew if a bleed would be my last and I'd cruise through the remaining weeks, or the next one would be 'it'. After a while I just got so worn down by it all - institutionalised, frightened, exhausted. It's so hard and although you KNOW you're in the best place should anything go wrong, it still doesn't make the days go any easier or quicker or make the waiting any less worrying.

As for when they give you the c-section, it really is just a question of balance - I realised afterwards that my consultant had really been playing a very skilled game of 'chicken' with the bleeds and waiting as far as he could. It really was a balance between keeping the babies inside me for as long as possible (as this really was the best place for them) and trying to predict if and when I might bleed to much. Once I had a really big bleed I think he just got too spooked. I was told that they could potentially give me a c section at any time and they actually got very close at 32 weeks after one of my big bleeds. But in the end my consultant decided to gamble on a bit longer. At the time, that drove me mad as I was desperate to be out of hospital, which of course made me feel incredibly guilty (here I was, putting myself and my need to get out of hospital above my babies need to stay inside me) but I think it was just a measure of how desperate and fed up I was.

In the end I negotiated 36 weeks for my caesarean, although I had to work hard to get this as it was originally pegged for 37 weeks. However, I was getting quite depressed by this stage and crying every day and threatening to 'check myself out' (as if I was staying in The Ritz.....) so I think he grudgingly compromised on this. In the end what swung it was the bleed just got too big and I don't think he wanted to risk another one - I lost a lot of blood in a matter of a couple of minutes - about a litre in two minutes and although it tailed off quickly and slowed to a trickle, the volume and force of it coming out of me was totally different to anything that had happened before.

You've been so unlucky but it does sound like your consultant is very switched on. It also sounds as if, like me, your bleeds are unstable and continuing, so the likelihood is that, as you said, you probably won't make it to 38 weeks and your scheduled section. Your babies won't be any the worse for coming any time now and really all your consultant will be doing is trying his best to gamble the balance between getting you and your babies as far along as he can, and getting them out before a dangerous bleed.

It won't be long and whatever happens it will be over soon and you can move on from this. I'm thinking about you a lot and really hope things settle down and the next few days/weeks whizz by.

K

Yes kitstwins it sounds like our experiences are very similar. But nobody at all seems to think that my mental health is a relevant consideration. I know that having a baby in scbu would be terribly worrying too but I feel (perhaps wrongly) that once she is on the outside some of the pressure and responsibility will be off me. E.g. Dh can spend some time at the hosp with her and I can spend some time at home with dd. Also I'm frightened for myself if the bleeding is very bad and would rather have the op done in controlled circs, not when I'm having a big bleed.

Anyway, counting down the days now, 14 to go! Thanks everyone for your continuing support. Rek x x

Hi Rek... I don't know if you feel you need it or not but I was feeling so down in hospital that I managed to be able to speak to a psychiatrist once a week (as I have suffered with depression in my past and also PND) Do you think it may help to speak to someone???

They didn't bring my section forward at all even though I was in a terrible mental state. I had an original date of 14th April I then found out that it wasn't a consultant from my hospital doing my section, so I asked if they could change it. They did to the 15th... There I was all gowned up and ready to go and the consultant came to see me (we had become firm friends by then!) and said he couldn't risk doing it that day as he had 3 emergencies and it said it wouldn't be him doing the section (as it would have been around 3 in the afternoon) I needed so moved it to the Thursday. He cancelled his whole diary for me for the following day to make sure he was there to do it...

I hope you have a great consultant like I did. Its not long now... Only one more time of eating the whole food menu take care Rek and remind yourself of why your there...

I will be thinking of you lots (as I always do)... Just think you have a very special and (what I call) miracle baby there who is sooo determind to be here...

Love to you and DH and DD xxxxxxxxx

Rek I felt exactly that - as if my mental health was absolutely worth scratch; at the bottom of the pile in terms of importance. And of course on one level it was and should have been, as the most important thing was that the babies were safe and well, but at the same time I don't think they should underestimate how emotionally debilitating a long stay in hospital (with such a dramatic condition) is.

Although it wasn't diagnosed I know I ended up very depressed in hospital and I think counselling would have helped hugely - certainly in coming to terms with things afterwards so I second Cazzabens suggestion of looking into this. As it was, I had a sh!t caesarean (entirely unrelated to the praevia but it didn't help matters....) and was left to get on with premmie twins and the aftermath of a long hospital stay. Everyone assumed I would instantly put it behind me and crack on with the 24/7 slog of caring for twins without so much as a wobble but the reality was very different and I wish I'd accessed some form of counselling during my stay in hospital as I think it would have been hugely beneficial. Instead, I had to throw myself into it without any acknowledgement of the crappiness of the previous month; as if the birth of my babies eclipsed all that went before and made it irrelevent. I think in an 'ideal world' and on paper we'd all think like that as obviously the most important thing is that your babies are born well, but it's trite and wrong to ignore the journey that gets them there. It still has to be acknowledged and processed.

Rek I totally empathise with all of this - I really felt at the end that my babies being born and being in SCBU for a short while was preferable to the horrible bleeding and the hospital stay and the threat of the major bleed. Which of course crushed me with guilt as I knew it was 'wrong', but it was a sign of how hard it all was and how traumatic I found it all. I'd simply got to the end of my rope. It's totally understandable and how else are you expected to feel? At the moment the burden and fear is all yours and although it's rough on your family (your husband and your toddler) it's YOU that's sitting out every day and night in hospital on high alert. Doctors forget that I think - they just tick a box on correct clinical procedure and don't really consider your emotional struggle with all of this. To them it's just facts.

If it helps, I KNOW exactly how you feel. I've been where you are. All I can say is that I really feel for you and hang on to the thought that it will be over soon. You have a final, definitive date so in 14 days the nightmare wait will be over. You're being so brave about this.

K

Dear cazzaben and kitstwins, you are so right. Ironically I was hoping to access some counselling before I came in here to deal with some of the issues around dd's birth. A number of things went wrong after she was born, not all of them in anyone's control but I associated much of it with lack of support in the hospital after the birth. So, even more ironically, I was looking for help to get over my fear of the hospital! My mum is a psychotherapist so she was on the case looking for a colleague to help me out, but of course with all the drama if bleeding etc it has gone by the wayside. But I think I should take it up again.

You are also right kitstwins that getting home again with a new baby seems like a massive hurdle. I think that cazza said at some point that she found it difficult to reassert herself with her ds, which is something that worries me a lot because in the last couple of months dd seems to have hit the terrible twos early and is incredibly assertive and angry if she doesn't get her own way. Most of it is struggling with not being able to express herself I think. I can't imagine what it must have been like for you kit with twins.

Sigh. Anyway, time to get on with the day, best foot forward etc etc! I am quite a positive person in RL but it helps no end to talk through some of the less positive stuff here, so thank you for being so patient! Lots of love, rek.

Good girl Rek! Keep that foot in front! I put my neck out when I answered you (Monday)but as I said then, it strikes me as all a matter of BALANCE. There are no rules in this situation and no definitive text book, (and the Baby wouldn't have read it anyway)As is shown by the responses, no 2 pregnancies or births are the same, far less are the personal circumstances & issues inside the mum's head. We are all individuals, with different needs & concerns and different ways of dealing with any situation we find ourselves in. That's what makes the human race human! We are all here for you, offering anedotes & ideas but ultimately your situation comes down to what happens in your body & how those around you (your medical team & yr family) handle things. Try not to worry about yr dd - you will soon be home & this glitch in her little life will soon be forgotten. Her world is up-ended at the moment but you will quickly be able to stabilise things again with the support that is obviously there. I wish you well & send love & kind thoughts. By the way, Kerry is now 36+3 & hoping to sit it out till 11th May -although we thought there were similarities in yr situations, it just goes to show the differences. This is the first baby so all I have to worry about there apart from the welfare of Mum & Babe is how their dogs will respond! Not the same kind of concern at all!
Thanks to Cazza for not dismissing me as uninformed! I responded as a Mum.
Take care, love. Speak soon, Glynis xx
Take

Hi glynis, I'm so glad you said what you did, because everyone in the hospital makes me feel so guilty for wanting this to all be OVER! Really glad that Kerry is still doing well, my experience with pets is that our much beloved cats (definately my baby substitutes!) had to very much take a back seat when dd came along. I hope the dogs are ready! Lots of love, rek.

Kits... Thats awful how you had to go through that, You summed it up very well how I felt too. I remember someone telling me (while I was in hospital) that I would forget my experience and do it again... At the time the comment was made a very good friend of my MIL's was visiting me (she is 64 and had spent 3 months in hospital with her second pregnancy) She turned round and said quite forcefully 'No she won't forget her experience here because unless you go through it you will never know how it feels' She was amazing and never really talked about her experience but would just talk about all those things that weren't really important, you know?

I remember coming home and just walking outside in my garden for the first time... It was a real awakening...watching the birds and watching the sun shining. Just simple things like getting a glass of water from the tap and having a shower with the door open or going to toilet was amazing. My house seemed a bit strange as people were putting things in different places. But it didn't take me long to make it mine again. It made me appreciate and re-evaluate what I had taken for granted for most of my life.

Rek you are going to get through this and your going to have a brand new addition to your already lovely family. It will be hard at first. I won't lie but it will be worth it when you hold your new little one and take him/her home and being with your DD. It seems miles away now, I know, but you will achieved something amazing. I know childbirth is a miracle in itself but you can say that you fought long and hard for your family and it is an experience that will change your life forever (but for the better).
Don't be so hard on yourself for what your feeling Rek its so understandable. Never let anyone make you feel guilty, Kits and have experienced what your going through and we both say the same... Please do try and speak to someone

Lots of Love xxxxxxxxxxxxx

Gosh, after reading this thread, I cant believe how brave you all are compared to me.

I have just spent 3 1/2 weeks at the hospital after having a total of 3 bleeds. My placenta is completely covering the cervix and has some seperation.

Im on 27 + 6 days so I have been let home with weekly scans until I reach hopefully the 34 week mark, then I will be readmitted.

I havent bled in 2 weeks, but im constantly walking
on egg shells terrified of what is going to happen.

This morning I have been having some tightenings, nothing painful just braxton hicks type feelings. Im practically in tears as I dont want nothing to happen, but dont want to phone the hospital either incase they make me go back unnecessarily.

Does anyone know if these mild tightenings are a sign of a bleed or early labour coming. Im only out of hospital since Friday and the thought of going back for a possible 3 months is too much at the minute

I have 3 other children, 14,8, and 16 months.

Leaving them was the worst thing ever for me the days in hospital seemed like the longest days of my life.

Rek - just checking in, no news must be good news.

mrsMoc - i know how you feel. I don't know the theory but I never had tightenings before bleeds infact the last bleed before DS arrived, I woke up, went to toilet, got back into bed and thought I'm going to bleed now and I did. My last two bleeds (32wks and 35wks) were after very busy weekends and lots of walking etc. So I do think that rest and childcare are a priority for you - I know it will be hard but you have to do anything you can do to get to the magic 36. also have an overnight bag packed and ready to go aswell as people who can look after the children at short notice. Try not to go too far from your hospital either. We cancelled a trip to london because didn't want to take the risk of a bleed in london and then me being admitted 100miles from home and no support whatsoever. good luck with the rest of your pregnancy.

Hi Rek - Been busy over the weekend with the B&B but keep thinking of you; only a week to go now,eh? Kerry is now 37+2 & in 5 days our baby will be here! I hope you or someone will post your news as soon as it happens as there are a lot of us who feel we know you now. Hope I will have access to the "old email machine" at that time but expect I'll be in Luton receiving our own good news. Good luck, good wishes. It's all going to be fine now after all our combined fears. Take care love.
Big hugs, Glynis xx

Thanks Twinklytoes, I have a scan with my consultant this morning so will ask then about the tightenings, they have only started happening since I left hospital.

I have been doing a lot of waking as I thought this was the only type of excercise I was allowed. I still have a while to go. 28 weeks today yay, cant wait till im hitting big figures lol.

Hope everyone else is doing good

Hi rek... Hope your doing ok... Its been a while!! I've been checking on here everyday and haven't heard anything so I hope everything is going well for you xxx

Mrsmoc what an awful situation to be in. I was 29 weeks when I was admitted and stayed for the long haul I had DS2 at 38+3!!! I just wanted to say that I had some tightenings when I had my big bleed not proper contraction but throughout my 3 month stay I had them on and off.

I think its just the womb is being aggrivated by the bleeding. I didn't worry too much though as I was being monitored and I was in hospital anyway. I hope everything turns out ok for you and that you don't end up in hospital for a long time take care and try not to do anything!!! Even walking can be bad (stupid I know) best just to relax and not do anything. Take care xx

Hi Glynis!

Wow!!! 5 days to go I bet its felt like forever! Well done to you and Kerry and all the family. Let us know when the little one arrives... Take care xxx