The Previa Thread - Page 4

[Xiaohua]

Originally Posted by studentmomma

. It's so disappointing to want a natural birth and be denied because of this...

This is a silly/hard admission to make but I have a few friends who take the scheduled c-section route... and I just wonder why this isn't happening to them. Why would it matter anyway? (That's horrible, right?) But to want this for yourself and your baby and then be told that you must have a c-section... I suppose many women have that sort of feeling. Just frustrated, I guess.

Yes, exactly how I feel! There are tons of women who are CHOOSING c/s deliveries anyway, so why can't the previas all happen to them???

I am 32 weeks with a complete previa. It was diagnosed at 21 week u/s and followed up with repeat scans at 24, 28 and 30 weeks that have not showed any changes. I was so, so, so hoping that it would move, but it hasn't, and my OB does not have any confidence that it will now. Sigh. I thought there was a good chance of movement, and still is a very, very small chance of a miracle even at this late date. It is not centered, and 95% of the placenta is on one side of the cervix. The problem is that they all say this is a massive placenta, far larger than most. It actually starts at the fundus, runs all the way down the posterior wall of the uterus, swings to the left and crosses the cervix a bit at the bottom. I have asked how much overlap there actually is, but they won't measure. They say it doesn't matter how much overlap there is, if it is completely covering it is completely covering both sides. They won't actually do any measurements unless it moves to a partial or marginal previa.

I am supposed to have a few more follow up scans, not to track the placenta, but to make sure the baby's growth is normal (not IUGR). But as the placenta is so massive, I don't think there is a huge risk of growth retardation.... and so far baby has been measuring significantly ahead.

Anyway, I am so bummed about the scheduled c/s. I was really hoping for homebirth. I have had three months now to get used to the idea, and I am still depressed.

[Burnindinner]

I'm so sorry, xhiaohua. I know it doesn't help to be one of the few times a c/s really is medically necessary. It still sucks, and it's still hard.

[aikigypsy]

I had a good appointment with my CNM the other day, and got to ask some more questions about the placenta's position. Aparently the ultrasound report said that it was posterior, which means that it's probably not centered over the cervix, which means it's 99.9% sure to move up. I asked her about maybe getting it checked again before 28 weeks, and she said that there really wasn't any point since it has to be a certain distance clear of the cervix before I'd get the OK to go off pubic rest.

So now I'm just waiting another 8 weeks for the next ultrasound, but I'm optimistic that all will be well then.

[earthyamber]

Bumping this thread! It sure has been great reading everyone's stories and learning more.

I am 15 weeks 5 days and I started bleeding 5 days ago. It woke me up and it wasn't heavy, but definately there. I have been having spotting off an on (heaviest the 1stt day and the 3rd day) that still scares me. I had an ultrasound on Monday and baby is fine (thankfully). They said my placenta is covering my cervix at least half way (she struggled to get exact placenta edge) and that it is the cause of the bleeding. I am on pelvic rest and semi-bed rest (even walking a 1/2 mile makes me bleed). I see my OB next week to find out more about what is going to happen next. The ultrasound tech said it is very common for it to move and be fine but the bleeding scares me terribly.

Anyways, I am happy to hear about everyone else's experiences with this!

[momtoalex]

Joining the group! Diagnosed with marginal placenta previa today after an anotomy ultrasound. I will be 22 weeks on Friday. Worried sick about this, although I understand that there is a lot of hope.

[MujerMamaMismo]

Looking for advice re friend with complete previa

Hi all,
I hope you don't mind me crashing your thread. I'm looking for some sensitive advice for a friend who has a complete previa.

My friend is 25 weeks pregnant and was diagnosed with complete previa at 19 weeks. She has been hospitalised with bleeds twice since then and has checked herself out AMA both times. The second time was today. She is a teacher and very attached to her class of 5 & 6 year olds and despite being told not to go back to work, she is insisting on it. I don't know what to do or say - or if it is even my place to do or say anything.

This is a much wanted baby but since she's actually been pregnant, my friend has been so consumed by fear of something happening that she's been close to denial about even being pregnant. She hasn't read a single pregnancy book, nor anything about previa. At one point they thought the baby may have had an intellectual disability and while they were waiting for conclusive results (for 3 weeks) she checked out of the pregnancy entirely and really did deny she was pregnant. The baby has been cleared for any disability.

I'm the only person she's talking to about her pregnancy, other than her sister who lives on the other side of the country and is a doctor. I'm sure her sister must be very concerned too and I really wish I could talk to her but I know that would be over-stepping the mark. She's not even telling her partner the whole story and when I mentioned something about possible bedrest a couple of weeks ago, he was genuinely surprised.

Can I tell her she's being stupid to return to work? (Is she being stupid to return to work?) I just don't know what to do. After all, it's her body and her baby and my support of her is unconditional but it's very hard to sit by and watch her make ill informed decisions.

Any advice?

[MeepyCat]

That's a really hard situation MujerMamaMismo. My take on it is that:
1. Yes. She is being stupid to check out AMA/return to work.
2. We may not know the whole situation.

In my experience, doctors get all kinds of twitchy just being *near* a previa patient. If you're anywhere but the OR, they are nervous. I was, at one point, hospitalized for seven days, not allowed out of my room, with nurses coming in to scold me for sitting up too much, after a very minor bleed. So the AMA bugs me, but not as much as it otherwise might. I wonder, though, if your friend is being honest with her employers about her condition - if she's checking out before the point where an extended absence would trigger a requirement that she get a doctor to certify that she's okay to return to work. The last thing the school wants is a worker's comp claim related to this, so if they knew, they'd probably bench her for the duration. (That said, if you call and tell them, there is nothing they can do - they can't see her medical records without her consent, they can't put her on leave on your sayso. So nothing you can do there.)

On the other other hand, the school year is almost over. If your friend just really needs to collect her paycheck for the next few weeks before she agrees to put her feet up, I'd want to know how much/how often she lifts or carries things. If she's a gym teacher, I practically think she should be committed, but if the most strenuous thing she does all day is help someone take off their pants to use the potty... I'm not thrilled, but okay.

And to go back to the "no that's stupid" end of things - a bleeding previa is a bad previa. It will bleed again. It's just a question of when. And how much.

Tell her you're worried. Tell her that you want her to be healthy. Ask if there's anything you can do to help. Point out, if you like, that the signs here suggest she's headed for an early delivery. Suggest that she involve her partner (she *is* on pelvic rest, right? RIGHT??), and line up some help and do some of those late-pregnancy chores like getting a carseat.

I hope it all turns out okay.

EDIT:

So, I wrote this in a hurry this afternoon, before I had to go do kid pickups, and here's the point I think I really want to lean on - your friend needs to be on pelvic rest.

Bed rest is controversial. Different hospitals and different doctors follow different protocols regarding recommending bed rest with previa. No one is entirely certain that it helps.

By contrast, pelvic rest is not controversial. In previa cases, there's a bit of a chicken and egg problem - cervical dilation irritates the placenta, while placental position irritates the cervix, potentially causing dilation. It worries me that her partner doesn't seem to know what's going on mostly because pelvic rest is the sort of thing you notice when you're in a relationship.

Your friend should not be having sex, she should not be having orgasms, she should be avoiding nipple stimulation, she should stay adequately hydrated, she should call her OB if she's having frequent Braxton-Hicks contractions that don't go away after she pees, lies down, and drinks some water. Also, she shouldn't hold her urine any longer than she has to, because that can lead to UTIs, and because a full bladder can irritate the uterus and cause contractions.

If your friend is not known to be on pelvic rest, please find some way to casually mention her medical stuff to her partner. Something along the lines of "Hi! I was calling for <friend>, but before you hand me over, how are you doing? I know these complicated pregnancies are tough on partners. Gawd, how much does that pelvic rest thing suck, huh?" Or you could helpfully email both of them some links.

[aikigypsy]

Originally Posted by MeepyCat

In my experience, doctors get all kinds of twitchy just being *near* a previa patient.

Yup, that's the doctors I've seen locally! The only one who didn't get all freaked out at me is a high-risk OB in a teaching hospital who has dealt with TONS of previa patients.

The CNM at the local hospital told me that I needed 5 cm clearance (not 2cm) to attempt vaginal birth. Argh. It looks like I'm going to have to camp out 3 hours from home for 3-8 weeks no matter what, even if my placenta (still a complete previa at 30 weeks) moves away from the cervix.