Need advice - 27wks complete posterior placenta previa...

[Shoxie]

Hi mamas, sooo sorry for the length of this, but I'm just beside myself...

This is my 3rd pregnancy. At the 20w u/s, I was told that I had complete posterior PP. I saw the screen, and it looked like the edge of my placenta covered the os, not sure of the measurement as the report didn't list it.

My OB, who is like a midwife, honestly, wasn't concerned. At 25.5w, I spotted on and off for a day and was referred to the L&D unit to get checked out. Perinatologist did a bedside transabdominal and then transvaginal scan. I told her of the complete PP "diagnosis" at my last scan. Miraculously, she said that it was now marginal, .68cm from the cervix. I was elated. She then said that my cervix was measuring short at 2.3cm. She did say this may be normal for me, but that I should be on modified bedrest until I got another u/s in about 10 days to check that it wasn't shortening further.

Fast forward 11 days to this past Monday. I go in and my cervix, at the shortest measure, is 3.1cm which is normal at 27w. Fantastic! I ask the sonographer if the machine in L&D is just not as accurate? She replies that it's very good and comparable to what they have in the Maternal Fetal Medicine office. Ok, I let that go, as I know the cervix is pretty dynamic.

Then, another peri comes in to look at the u/s, and as he's walking in, he says something about, "Oh, I see we have a placenta previa." I said something about it being marginal now, but he walks over to the screen and shows me that it's still covering the cervix. It seems like a very thin, almost "ratty" (for lack of a better word) white area. To say the least, I was shocked, and completely saddened. He said it means I'll "just" have to have c-section (like that has no risks, ugh). And he's not optimistic it will move. Wants me to come in at 35w for a follow-up.

I ask how this happened, and he says the previous peri could have looked at a different angle - is that even possible? My doctor, through his receptionist, said that the bedside scans are not as accurate and he's seen this happen before. What? That scares me, as I'm assuming this is what they're using in L&D, and if they're not accurate, what good are they?

I feel like, had my cervix not been short, I would've been given no restrictions (maybe pelvic rest) due to the marginal PP finding. WWYD? This is not something trivial to me, and if there's a chance that it is marginal (which I know is highly unlikely), should I ask for another scan a bit earlier, maybe 31w? I have two small children and my 63YO mother helping me (she's running on fumes at this point), and I'd like to be more certain of what's going on.

Has anyone had this happen? I'm so bummed, and I'm not really confident in the abilities of the peris at this hospital, especially considering one of them could deliver me. Neither my doctor nor the MW has called to explain other than the initial returned call I got through the receptionist.

TIA so much for reading, if anyone gets to this point.

[MaerynPearl]

I read it... all I can say is I will be hoping for you

I had partial previa at 21 weeks that resolved by 27... Im not sure about what your chances are but i suppose it probably depends some on just how much it is covering the OS by. You still will grow some before 35 weeks so I will be for ya that it moves!

[Shoxie]

Thx, Maeryn, for your kind words. I just wish the marginal PP finding were actually the right one - hoping against hope, you know?

[MeepyCat]

Hi Shoxie,

I had placenta previa with my most recent pregnancy. This is what I know: The bedside and portable ultrasound units in L&D are the crappy ones. They are the older machines that have been replaced in the radiology department, or they have been around the unit for years getting progressively more beaten up. They are good for checking fetal position, for figuring out why the monitors aren't picking up the fetal heartbeat, for dealing with miscarriages... but they aren't up to showing the details on placenta previa.

The other thing I know? This sucks. I'm so sorry.

And third - "Just a c-section"? There's a word I want to use to describe that, but I think I'm not allowed to say it here. The definition of minor surgery is "surgery that happens to somebody else."

Nine months from the end of my pregnancy, I can assure you that everyone involved is fine, but it was a scary trip. This is a big deal.

[JTA Mom]

Originally Posted by MeepyCat

Hi Shoxie,

I had placenta previa with my most recent pregnancy. This is what I know: The bedside and portable ultrasound units in L&D are the crappy ones. They are the older machines that have been replaced in the radiology department, or they have been around the unit for years getting progressively more beaten up. They are good for checking fetal position, for figuring out why the monitors aren't picking up the fetal heartbeat, for dealing with miscarriages... but they aren't up to showing the details on placenta previa.

The other thing I know? This sucks. I'm so sorry.

And third - "Just a c-section"? There's a word I want to use to describe that, but I think I'm not allowed to say it here. The definition of minor surgery is "surgery that happens to somebody else."

Nine months from the end of my pregnancy, I can assure you that everyone involved is fine, but it was a scary trip. This is a big deal.

Yes, this. Also, in the L&D they don't do as intensive a look as a peri would. They are trying to see if there are major issues. If there are none, no further looking. Once the OB determined you were closed and no major bleeds, etc, to them, the 'emergency' has passed. Also, as good as OBs can be with u/s, a tech or peri is MUCH better. This is what they are specialized in, kwim?

I am so sorry you are looking at a c/s. I know it's incredibly scary and heartbreaking at the same time. If you do have PP, it is the safest way to go. I think, research a lot, even post about what to expect on here, etc would be helpful to making peace with it. It is major surgery but one that many on here have experienced.

My ds2 was a c/s, but not planned/known about ahead of time. For me, had I known what to expect, what was normal, the sequence of events, the ability to write a birth plan specifically for the c/s, and time to accustom myself to it, it would have been a completely different experience. For me, and a lot of women, I think a lot of the trauma of a c/s was the unexpectedness of it, kwim?

A

[Shoxie]

Thx so much, JTA. I'm just really annoyed b/c the OB that did the scan in the L&D room was a peri - in fact, she works at the Maternal Fetal Medicine unit at which I had the second scan done. So, I don't really understand what could've happened. I was still bleeding at the time that I had the scan in L&D, and I mentioned the PP to the peri, so she knew to look for it and that it most likely caused the spotting.

It's just so strange. I thought maybe I had a small piece of the placenta above my cervix tear off but remain over it?? The peri in L&D put my hips up on a bedpan to elevate my pelvis and I thought maybe that small piece wasn't as visible at that angle and had pulled off the cervix, but at the MFM scan I was just horizontal in stirrups.

Honestly, I just don't understand how a peri could've made a mistake to that degree, kwim? She missed a total and diagnosed it marginal at .68cm away...and I would've never known any differently if I hadn't gone in again to check my cervical length...that's what really bothers me!

[Shoxie]

Thx, Meepy. That's also what I was scared of - that those machines are relatively crappy...that's why I asked the sono tech and was surprised with her answer that they're in fact just as good as the ones in the MFM office. Of course, I'm inclined to agree with you and not the tech considering my experience.

I need to speak to my OB/MW and really feel them out. I don't even get why they'd send me to L&D knowing that I have a complete PP with spotting if the machines aren't up to snuff and can't get a good read on the condition anyway. And why wouldn't the peri say something to the effect of "Just so you know, these machines aren't nearly as accurate as the others, so this may not be correct..." So frustrating!!