Twins 26 weeks low lying placenta and bleeding

[thorathora]

I am struggling a bit at the moment, and although I am a newbie MNer I would be so grateful for any advice/experiences you can all share with me.

I have an almost 3 yr old DS and am now pg with twins (26+4 today)

I've had small bleeds at 9,16, and 22 weeks and was admitted on tuesday this week with a larger one. Since then I've had two more bleeds during the early hours, this morning's was the heaviest with several small clots and gushes of blood. I was petrified.I have had steriods in case of prem delivery.

A scan today showed both babies growing OK and that the posterior placenta is 3 cm from the os and the other one too far away to measure (on vaginal scan). I am clinging to the hope that this means the bleeding should settle down.

I am just happy this evening to be back from delivery suite and on the ward (small mercies etc) but the uncertainty of what the next weeks hold is really hard to get my head round.I am scared to go to sleep incase I wake up again at 3am bleeding.

Our son is the result of IVF and we went back for a last attempt ot give him a sibling and now I just feel that we have embarked on a nightmare pregnancy (that is taking me away from him) with a range of horrible outcomes. Just feel that we were greedy to try.

Thora

Hi Thora,

Please try not to worry too much, although I know that this is a very difficult thing to do.

The positive outlook on things are that you are in the right place should you start bleeding again.

Your babies have had steroids which makes a huge difference in terms of surfactant production and lung maturity - the main difficulties that premature babies can have. Not all do these days, some babies born at this gestation don't require any assistance with their breathing, others may need some ncpap, others could be ventilated.

Your twins are nearly 27 weeks, which is so much better than 24-26 weeks.

The bleeding has stopped and hopefully it won't start again.

Have you had a look round the neonatal unit in case your twins make an early arrival?
I would recommend it if you haven't, you'll get a chance to see the type of equipment that is used and meet some of the staff as well,

good luck, hope everything goes ok

Hi Flappy,

Thank you so much for your reply. Touch wood I haven't had any further bleeding since thursday morning and turn 27weeks tomorrow. I am quite happy sitting on the ward at the moment (better than being whisked down to d/suite).

I have experience of working on the NNU here so am steering clear at the moment-they are all lovely and I have faith in them but just don't want to face the reality of a prem delivery yet!

Thora
XXX

Glad to hear you've had no further bleeding!

I know exactly where you are coming from with regard to working on an nnu and being pregnant/bleeding/decreased movements etc.

(feel about because no doubt you would have known everything I'd said)

Fingers crossed your twins stay inside long enough to avoid any admission!

Oh flappy don't feel like that! It is nice to be treated as a normal person-I only remember the babies who did badly....

Am now 27+2...next goal is 28weeks next Monday. So far so good but feel like a bit of a ticking time bomb...

ThoraXXXX

I had this. Twins, placenta praevia of twin 1 (partially covering cervix although it did move slightly away, although still in 'risk zone as only 2cm). My bleeds started at 23 weeks and I bled on and off until 35 weeks when they delivered, with regular stays in hospital.

What I had was very rare - an unstable placenta that they think peeled away slightly at one edge and caused lots of heavy bleeding on and off. Some bleeds were light but some were very heavy and very unpredictable. They mostly happened in the night too (apparently praevia bleeds tend to, although they don't know why...) so I can empathise with the fear of going to sleep and the panic of waking up. It's a horrible state of suspended fear and it's no fun.

First thing to say though is you're not greedy at all. This isn't some obscure punishment by Mother Nature because you wanted a second child. You're just really unlucky. Placenta praevia is more common in a twin pregnancy but there's nothing you can do to influence it or prevent it. It is just one of those things and it's not your fault. The bleeding is unlucky but it doesn't necessarily mean that you'll continue to bleed for the rest of your pregnancy as sometimes it settles down. However, your consultant will probably tell you that because you've bled it's more likely that you will bleed again, so you should have a prepared mindset for this. I stayed near the hospital (no long car drives, etc.), always had my mobile phone charged and ready in case I needed to call a taxi or an ambulance (never needed the latter - my husband drove me and in one case during the day I jumped in a cab) and I always carried my medical notes around with me.

I had steroids too and they really helped - my daughters were born at 35 weeks and didn't need special care as their lungs were fine. In fact, they were non the worse for all the dramas and it was just me that was wrung out and anaemic. The bleeds never seemed to bother them and I can say that with authority as one happened when I was hooked up to a monitor and being scanned and they carried on fidgeting and snaking around as normal.

It was NO fun and it's a crap way to spend a pregnancy - in a state of high alert and panic when you should just be floating around folding babygrows and faffing in your nursery, but sometimes it just goes this way. The good point is that you will get LOTS of care from now onwards and will be very carefully monitored so you can be reassured that you'll be in the most capable hands. I always knew that although I was having an utterly crap experience I was important to my consultant - he really cared about doing the best by me and my babies and he really watched over me.

My placenta praevia twins are now nearly three and totally unaffected by the dramas of the pregnancy.

Hope this helps.

Kitstwins-thank you so very much. Sitting here with tears in my eyes reading your story. It sounds very similar to mine and I am so pleased that despite all your bleeding you managed to get to 35weeks. That's fantastic.

Your practical tips sound good too. We only live about a 5 minute drive from the hospital and have lots of family support so I am hoping those factors are in my favour for dishcharge. I am hearing rumours that if I get to 28weeks (next Monday) without more drama they may think of letting me home for abit.The team looking after me are fantastic and I have every faith in them-which helps a lot.I feel very safe in their hands.

Thanks again, you've really helped.

Isobel
XXXXX

When carrying ds2, I was diagnosed with major placenta previa, because the bleeding can be so spontaneous I was placed on bed rest.
First bleed was at 28 weeks but I managed to deliver at 37 weeks, however due to you having twins I will assume you will deliver earlier than that..I spent my last 5 weeks in and out of hospital...good luck and I really do understand your worry at this time. I spent weeks feeling anxious

Hi Isobel,

I'm glad my post was helpful. The best news of all is that you're close to your hospital. I wasn't - a fifteen minute drive on a good day (or in the middle of the night sat on a towel!) and via the Shepherd's Bush roundabout so a potential for nightmarish traffic jams and delays. Given this, my consultant was much more iffy about my going home and so from 30 weeks I was kept in hospital on bedrest which was dreadful. However, my bleeding was heavy, my babies were IVF and I didn't live close enough to make the risk worthwhile if you like, so I didn't have much choice.

The fact that you are close and have family support really stands in your favour. Your consultant may lay the pressure on you somewhat as twin pregnancies ARE deemed more risky and they get more twitchy about the fact that there are two babies in there (and TWO babies, not just one, to get out in an emergency, etc....) but I think if you can promise to be prepared and always come in at the slightest bleed and always have someone with you then they'd probably be okay for you to go home. Of course they can't make you stay in hospital as it isn't a prison, but they can give you the hard sell and appall you with horror stories and dire warnings, as they did with me. However, I'm willing to bet that had I lived five minutes away I could have negotiated at least a couple of weeks out of the five that I spent in hospital at home in my own house.

28 weeks is the magic number. I went into labour at 25 weeks and 3 days which they managed to block with drugs but I remember my consultant telling me I had to try to get to 28 weeks; that this was the magic number for babies. Of course, he then started nagging me to get to 30 weeks and then 32 and then 34 so he was clearly never happy, but I remember him being quite cheerful when I got to 28 weeks!

Placenta praevia and bleeding is awful and such rotten luck but there are plenty of people out there (and on Mumsnet) who've gone through it too. They've all been in exactly the same state of fear and anxiety but you DO get through it and you do come out the other side. Usually slightly frazzled and anaemic but always with a baby or babies who are blissfully unaware of the fuss and panic they've caused.

They sent my placenta off to be studied (part of a twin study apparently) but also for research into praevia and I quite fancied writing 'bstard' on the tub so the pathologist would know it was examining an arsehole of a specimen.

You'll get there. It's dreadful and I remember it well even now, but you do get there.
K

Thanks so much again Kitstwins and also evaangel2-it is good to hear that bleeds early on don't neccessarily lead to disaster!

I am indeed v lucky to live so close-I was seen by my team this morning and they are mentioning the possibility of day release next week after I turn 28 weeks-which seems like a great idea to me-can be at home with ds and backup granny during the day and then sleep here. I'm still really scared at night.A 15 minute drive through London when bleeding doesn't sound like much fun.

Prem labour at 25 weeks must have been extremely scarey-I know how petrified I was last week when I had the bigger bleed at 26+4 and thought they might section me there and then.

I love your story of your placenta going off to the lab labelled with your discontent! I am planning to join some studies using the placenta/cord blood and may well do the same!

Thanks again
Isobel
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Hi there isobel and hi kitstwins!

I have had a recent experience with low lying placenta - kits twins was really supportive then (thank you!). It wasn't twins but it was very low lying, I bled at 29 weeks and was in hospital until 36+2 when my dd was born. I had 2 heavy bleeds and went into labour at 34 weeks, but almost constant light bleeding the rest of the time. The doctors will do everything they can to keep those babies in as long as possible, good for them of course but might drive you mad! I really sympathize with your feelings about your older child, I felt so guilty about the impact on my dd1 (20 months), but since I have been home she has taken the whole thing in her stride, as if it never happened. And she loves her little sister. Dd2 had underdeveloped lungs and lost a lot of weight but she is absolutely thriving now.

I just want you to know that however horrendous this experience is it does all have a happy ending and your new little ones will be so worth it. All the best!

Thanks rek21 congratulations on your dd2- I'm so glad to hear she is doing so well now, and it's also wonderful to hear that your dd1 took it all in her stride overall. DS keeps asking me to come home, but I've just spoken to him and Daddy and they are getting in the bath together with water pistols!!

Isobel
X

Just thought I would let you know that I ended up getting discharged on friday after a different Consultant came to see me! I think he felt sorry for me and after ahving no bleeding for a week he thought it was OK to set me free.

Still have that "ticking time bomb" feeling but so much happier to be at home with my boys. And 28 weeks today! Yipeee!

XXXX

I'm back in hospital now at 30 weeks after a rather big and scarey bleed at home last week. I think I may be here for the duration now...

Words of encouragement gratefully received...

XXXX

Hi Thorathora,

Sorry you're back in. I think with placenta praevia you do in the end become nothing more than a timebomb and I know for the consultants it becomes a bit like a game of 'chicken'. They sit there evaluating the risks and balancing it all up. How long can they keep the babies cooking versus should they get them out in case you have a really, really big bleed?

I think this is where consultants come into their own - it's about a lot more than guesswork on their part and even though you can feel like nothing more than a clinical study in a casebook, to them that's what it has to be about. You are a complex medical case requiring skilled assessment and evaluation. Becuase of this, your emotions can feel irrelevant and I know I struggled with that. I HATED being stuck in hospital and struggled with the boredom, the isolation, the fear, the shIt food, the sleepless nights, EVERYTHING. Not being in my own home whist everyone else seemingly got on and enjoyed their pregnancies felt very unfair. You lose so much with placenta praevia - the blithe enjoyment of pregnancy, the fiddling around at home for the last few weeks of your pregnancy, the lazy trips to coffee shops and baby shops on your maternity leave. I got none of that and it really upset me.

Everyone trips over themselves to say that you're in the best place and you absolutely are. If the doctors are getting edgy about you staying there then it really is probably the sensible choice to grit your teeth and take their advice. They are covering their backs, but only because the risk of further bleeding and a very big bleed is present and you don't want that. If you do have another big bleed then hospital really is the best place for you and your babies. At the same time, it doesn't mean that you have to enjoy it or be happy about it. You're allowed to be totally f*cked off at your bad luck as staying in hospital waiting to bleed is a pretty miserable state of affairs and not one that anyone would enjoy. A hideous mix of acute boredom and acute fear are not a great state of mind day after day.

If it helps, this is what I did to get myself through my month in hospital. I was still really naffed off and went slightly barking mad, but it did help.

1. Turn your day around small events. I spent all morning washing my hair or giving myself a 'home facial'. Get someone to bring you in sachets of conditioners and face packs, etc. I would blow dry my hair into smooth brilliance and wander around with clay masks slathered on me (attractive look!).

1. Plan your day. I'd break it up into sections. The morning spent having my breakfast and walking to the hospital shop for a newspaper. Then I'd chill out for a bit or pain my toenails (would take me hours as I had to navigate my giant bump) and then go for a little walk around the grounds.

1. Go for little walks. The midwives originally got a bit grumpy about this as they said I had to be on the ward all the time in case of a bleed but I really think I'd have gone mad if I'd done as I was told. In the end, I had a bleed one evening and no one answered my buzzer (apparently it wasn't working through to the nurses station) and so I lay in bed for twenty minutes pushing the buzzer wondering where the hell everyone was. Thankfully the bleed was small and stopped pretty quickly but I did point out to them that if it had been the massive bleed that they kept warning me about then I'd have been toast in the 20 minutes it took for someone to wander into my room. After that I decided I had a bit of leeway during the day. I'd only do little walks about the (very drab) perimeter of the hospital and I always took a bit of paper and my phone with me. The paper would have my name, my hospital number (on my wrist tag also) and details about my pregnancy - praevia, twins, how many weeks I was. In the event I never bled on a walk and actually rarely bled during the day. If I did they were very, very light and short in duration.

1. Read. I'm a big reader anyway but I read every magazine going. I got my husband to bring me in books and I did the Telegraph cryptic crossword every day (I got very good!). In the end, even I was bored of reading, but it did kill a bit of time, especially if I broke it into one of my time slots rather than just reading endlessly i.e.. I'll read from 10am to 12pm and then I'll go for a little walk....

1. Beg for visits. I now realise that I didn't get visited nearly enough. Only my husband every evening (from about 6.30 after he'd left work) as all my friends worked, my hospital was far away and I don't have any family. My in laws live 200 miles away and drove down a few times but I didn't have many visits. Maybe one a week, which isn't very much when I look back. Until you're in the sitation yourself I don't think you realise how important visitors can be and so I now think I should have pushed more; rang up my friends and said "I'm going stir crazy, please visit". That way my husband might have got a bit of a break also as he spent every night for a month at the hospital, usually mopping up my tears.

1. Beg for decent food. God, I struggled with the food. I lost weight in the end and certainly was all bump and eyesockets by the time my babies were born as I subsisted on vitamin pills, iron supplements (I was badly anaemic from all the bleeding), packets of mango and yoghurt from the hospital shop. Every lunch was an egg sandwich (the only one I could bear from the rather sad selection on offer in the shop) and dinner was a packet salad from a supermarket (courtesy of my husband). HOspital food was dire - a bit like aeroplane food in that it's okay for the first day but the endless rotation of mince and nuked vegetables was just too much. Again, I wish I'd got friends to bring food in. In the end we got clever about meals (packets of smoked salmon and pitta bread and salad made meals and sandwiches for me) but it was pretty crap. I still get tearful about the fact that my mother in law drove a 400mile round trip to bring me minestrone soup and roast chicken, which I can still taste.

1. Negotiate with the consultants and midwives. Don't be afraid to say if you're struggling with it all and are tearful. In the end I cried every day I was so strung out by it all. After a near solid day of crying my consultant agreed that I could go out for dinner in the evenings and so this meant decent meals and some time in the 'real world' (which I was strangely removed on - I remember how alien being in a restaurant felt). He also agreed that I could go home on 'day release' one weekend, although that never happened as I had my big bleed and section on the Friday. I'm sure they all thought that I was a complete baby and drama queen but being in hospital can be a real struggle and your consultant, rightly concerned with the medical implications of your care, can sometimes lose sight of this. It doesn't hurt to remind them that you've got emotions too.

I can't offer help with the issue of what to do with your older child whislt you're in hospital but I did want to say hang in there. As other posters have said, in the end it DOES end and you get to go home happy and well. It doesn't really help when you're stuck in hospital as NOTHING helps, but just hold onto that thought. One day soon you'll be home with your lovely babies and you won't have placenta praevia any more.

I so remember what this is like so I really feel for you. If I can help in any way then let me know as I'm based in London.

K

Hi Kitstwins,

Thank you so much for the message. Unfortunately I had a massive bleed later that day, last tuesday, and my boys were born by crash section that evening at 30+1.

They are doing well on the neonatal unit now and I am back at home after a nice big blood transfusion.

Thanks again
Isobel

Hi im 21 weeks pregnant and am slightly anxious as i have been bleeding for three weeks now .i found out i have a low lying placenta at my 20 week scan but my bleeding is becoming more frequent every other day,i have been in hospital three times this week,the bleeding is only slight at the moment but i am anxious that the next one will be heavier and i know at this stage my baby is not viable yet so i am starting to become afraid. Does anyone have any good advice for me or any positive stories similar to mine with bleeding early on ,i desperatly need some reassurance. thanks vicky

Thorathora I missed your last post but I just wanted to say congratulations on the birth of your twin boys. You had a real rollercoaster and it must have been pretty traumatic.

I think you're very brave as bleeding coupled with an hospital stay and then a crash section, pph and babies in special care is no small deal. It must have been really traumatic so I hope you're getting lots of support and care after what you've been thought. It often gets swept under the carpet once the babies have arrived as there is so much to do and no time to 'indulge' your own feelings, but I do hope you get time to process things. From personal experience, Praevia and an hospital stay can really take it out of you both phsyically and emotionally and it can take a long time to build yourself up again afterwards because, for so long after your babies are born, you're the bottom of the pile. It's hard, but try to take care of yourself too or make sure that other people are taking care of you.

vdoyle sorry to hear you are having bleeding. You don't say what the bleeding looks like - is it red or darker brown? Equally, were they able to pick up where exactly your placenta was? Whether it's just lowlying or actually over or semi-over your cervix (placenta praevia)? If it's just low-lying then the odds are that the bleeding will stabilise and the placenta will move out of the way into the 'safe' zone (around 90/95% of cases do), which is usually 3cm away from the cervix. Although I don't want to worry you, your consultant will probably tell you that the fact that you've had bleeding means that you're more likely to bleed again although it CAN settle. It's not a foregone conclusion and there are plently of people who've bled in mid-pregnancy from a low-lying placenta and then cruised through the rest of their pregnancy without a further bleed. It's just it's MORE likely if you've bled already. Unfortunately there's no way of knowing which one you'll be though which is why it may be worth pushing for another scan so that they can precisely pinpoint where your placenta is i.e. how lowlying it is. Equally, when you get to 24 weeks you can ask for steroids as if you do get further bleeds and the babies are born early then this will help their lungs. They tend to do two steroid shots over eight weeks for optimum effect so if you had the injections at 24 weeks then you could have the second lot at 32 weeks. I had two lots and my babies, born at 35 weeks, avoided special care and didn't need any help with breathing.

Bleeding is really worrying but the fact that it is light is a good sign. You're 90% likely to be one of the 90% whose bleeding stops and their pregnancy continues on as normal, but if you wanted peace of mind and more reassurance it might be worth pushing for a more detailed/extra scan just to see if you can pinpoint this placenta.

Good luck and I hope everything settles down. K

Thorathora thank you so much for your advice the bleeding is red fresh blood with small blood clots in it,i have had another bleed since posting the first message (4 this week).I am rhesus negative aswell so i keep having to have blood tests and anti-d injections every time it happens,im defiantly going to take your advice as i feel its getting worse instead of slowing down. thank you again

Hi vdoyle sorry to hear you've had a further bleed from your last post. It's horrible isn't it - before I was diagnosed with placenta praevia I just assumed I'd be like all my friends and just cruise through pregnancy? Instead I had the most highly medicalised and panicked of all of us and it really sucked.

I'm no expert but the red blood and clots is what I had during my bleeds so it does sound as if the bleeding is related to your placenta and it may well be very close to your cervix. Presumably you've been told to take things very easy? I was put on something called "pelvic rest" which sounded very quaint and almost Victorian, but actually turned out to be a long, boring list. No exercise, no strenuous activity, no sex, no orgasm, no lifting, no jumping....nothing that could irritate the uterus or cervix and trigger another bleed. Because I had twins I got lots of braxton hicks and I found if I walked faster than a snail's pace it triggered them, which in turn increased my risk of bleeding.

I'm sure they've told you all of this, but if you have a bleed go to hospital. Ring your labour ward on the way and turn up. Sometimes the bleeding can irritate the uterus, causing it to contract, and this can kickstart early labour. If this happens they can give you drugs to block this and they work. I had early labour at 23 weeks (disastrous!), 25 weeks, 28 weeks, all of which were blocked with drugs and in the end I made it to a very respectable and safe 35 weeks, which is good for twins.

It all looked bad for me in the early stages - twins and all the bleeding I was having and the labour scares but I got through it and my babies were born safe and well and absolutely none the worse for all the dramas. The 'good thing' with bleeding, if you can call it that, is that consultants and midwives take it very seriously and you really do get an increased level of care. Your pregnancy will be closely monitored. The downside is that you may have to prepare yourself for a hospital stay at some point but if you search praevia posts on Mumsnet you'll see some good threads with advice for coping with hospital stays, etc. I'm sure I've waffled at length on my tips for it in several posts.

Let me know how you get on with the extra scans. You might have to nag and push for them but it doesn't mean to say you're not entitled or allowed them. Sometimes you just have to ask as they don't always offer.

Take things easy if you can. The less you do the better I think as overexerting yourself can sometimes trigger extra bleeds. It's really hard though and I do sympathise. You don't deserve this in your pregnancy so I really feel for you.

K

hi kitstwins thanks for replying to my post.I have had mixed reports from doctors some said take it easy ,no sex , walking ,lifting etc and the last one i saw said just carry on as normal if your going to bleed the its gunna happen no matter what you do! So i must admit i was slightly confused as to which i should do ,i have taken it easy since thursday my last episode and so far nothing has happened , so maybe that was the right choice.

I have read some of the other threads and i have to say i feel a lot more at ease now its amazing how just talking to someone who has experienced the same thing can make you feel better,the doctors have been great with me and we have been joking about the hospital being my second home.One of my family members hasnt been supportive so it has been a bit hard for me ,basically tellng me (its not looking good for you is it,i dont fancy your chances ) THINGS I DONT NEED TO HEAR.
So its nice that there are people like yourselves out there . Thank you again.

vicky

Glad to hear it was helpful.

As with the conflicting advice I got this too although I erred on the side of caution and followed the advice about pelvic rest and took things very easy. It was hideously boring as I was superfit and active up until this point (ran lots before pregnant) but I figured that if I did leap about and do lots of stuff and had a nasty bleed I would always blame myself. At least if I took things easy I would know that the bleeding was not down to anything I did or didn't do but just one of those things.

There are two camps - those that think that the bleeding will happen regardless of what you do and those that think it can be influenced. I think there's arguments for both: Certainly, the majority of my bleeds happened at night when I was lying fast asleep in bed and not doing anything remotely active. But equally, the cervix and uterus can be affected by strenuous activity i.e. can trigger braxton hicks, which in turn could irritate the cervix and/or placenta and trigger a bleed.

Not much help as it's all fairly 'grey area' but I'd stick with your plan of taking things easy and bask in the knowledge that this means ZERO housework from now onwards. Hope all is going well and things remain settled. Keep me posted as I'd like to hear how you're getting on.

P.S. Can relate to the teeth-sucking, doom-merchant relatives too. We had a bit of "don't get your hopes up" and lots of sad looks after a few of my bleeds, which was incredibly irritating. Of course they were the ones who trotted out the old "You're in the best place" when I was in hospital on bedrest but never once came to visit me in this "best place". And once the babies were born these were the people who were tripping over themselves to to say "I KNEW everything would be alright!!!" which was both amusing and maddening at the same time.

Families eh?!

hi kitstwins
I seem to be the same as you because most of my bleeds are happening in the middle of the night or first thing in the morning, had a very small one today at work and had to come home due to hospital midwifes advice, but i have to say that things do seem to be improving as the frequency has gone down.
Yes i agree families are truly unique !!!