Ideas to make a placenta move?

[karen1968]

I just got back from an u/s where I found out my placenta previa is still complete at 31w4d. I have scheduled a re-scan for 35w4d (Oct. 25th).

Is there anything I can do in the meantime to help that darn placenta get out of the way??

I am going to try acupuncture, but I've never really seen any info on how to help a placenta move. Is it hopeless to try and better to just hope?

I had to have an induction with DS due to pre-e, and I was so very much looking forward to a homewater birth this time. I feel very helpless at the moment.

[CherryBomb]

There's no way to make your placenta move, afaik.

[Youngfrankenstein]

Originally Posted by CherryBomb

There's no way to make your placenta move, afaik.

Yeah, the placenta attaches and grows into the uternine lining. I think when it "moves" it's just the uterus changing shape with the baby where it can stretch to different places.

[karen1968]

Well, yes, I know the placenta is not a sentient being

so a more accurate question would be "How can I help the placenta move with the growth of the uterus rather than stretch or stick to to cervix?"

ETA: "moving" is the term most often moved when talking about getting a placenta to be clear of the cervix. So while a placenta can not move on its own, it CAN be "moved", in the same sense as moving a rock out of the way of a plow. What I want to know is if there is anything to do besides hope.

[MeepyCat]

Karen, the only thing you've got is hope. I'm sorry.

I had previa too. The only problem with saying that it sucks is that words fail to convey the dimensions of the suckitude. The only two factors that matter are luck and time.

At this stage, especially if you've had bleeding, the odds are really not fantastic. The only thing you can do is keep your feet up and take it easy.

[karen1968]

That's what really sucks. I've had NO bleeding. No spotting. No indications of previa except for the u/s. Which, I know, is about as conclusive as it gets.

I've not stopped dtd, or exercising, or any of those things that are "recommended" for women with previa. Which makes it all the more exasperating to find out it didn't resolve.

I have been reading some good things about acupuncture, so I'm going to try that.

[Earthy Mama]

I have previa too-though mine is only marginal-it only has 1 stinking cm to go! ONE!
I had an emergency section with dd2 (prolapsed cord) and was planning a HBAC. My MW, OB, and I were all certain that from my last US at 28W to this one at 32W it would have scooted out of the way, but NOOO. I get one more US in 4 weeks, but no one is optimistic.

[blessedwith7]

Karen,

That makes me nervous that you had no indication of placenta previa except for the ultrasound. What about all those mothers who don't have ultrasounds? My sister-in-law went through placenta previa. I won't go into details but it scares me. Hoping all goes well for you and baby.

Theresa

[MeepyCat]

Originally Posted by karen1968

That's what really sucks. I've had NO bleeding. No spotting. No indications of previa except for the u/s. Which, I know, is about as conclusive as it gets.

I've not stopped dtd, or exercising, or any of those things that are "recommended" for women with previa. Which makes it all the more exasperating to find out it didn't resolve.

I have been reading some good things about acupuncture, so I'm going to try that.

Karen, do you mean that you did or you didn't stop doing those things? If you did - yeah, I know how exasperating it is. The whole point of all of those restrictions is to avoid a crisis requiring the baby to be delivered early. In and of themselves, they do nothing at all, they're just an attempt to assure that you have as much time as possible for the baby to cook, or for the problem to resolve on its own.

I took a look at the page on acupuncture, and I have to tell you that it sets off my quackery alarms. The writer doesn't seem to have a real sense of the seriousness of the condition - they make it sound like it's kind of a bummer to be on bed rest, but if you were planning a c-section anyway, no big! There were two paragraphs in particular that grabbed me.

The concern with placenta previa is that the birth canal could be blocked by the placenta, either partially or completely. It’s possible the placenta could be pulled from the uterine wall when the cervix dilates during labor. This could cause bleeding and potentially be harmful to your baby, which is why unresolved placenta previa may result in Caesarian section delivery.

The use of the conditional in this paragraph is completely inappropriate, and their description of the consequences of previa is entirely too mild. "Could cause bleeding"? "Potentially harmful"? "May result in Caesarian"? Try will cause bleeding, will almost certainly be fatal if untreated, and will require surgical delivery. (Objections to conditional in this paragraph, as stated here, are not complete.)

The second paragraph that sets off my alarms is this one:
"Traditional Chinese Medicine is a safe treatment option that can resolve placenta previa."

Particularly in light of the prior, extensively footnoted, paragraph in which it's explained that nearly all cases of previa clear up on their own, this is a big claim, backed up by no evidence.

I'm not against acupuncture. If it makes you feel better, I think you should have it. But I think the big difference between women with previa who are treated with herbal formulas and acupuncture and women with previa who aren't is that one of these groups has paid for acupuncture.

[caned & able]

Have you had previous surgery on your uterus?

The placenta is known to move around the uterus during pregnancy, but it can get stuck on a uterine scar such as a c/sec scar.

There is still time for it to move.

[karen1968]

I had a d&c in Oct for a missed m/c. That's the only time anyone other than one of my children has been inside my uterus.

I know some people consider acupuncture quakery, and some of the conditional statements are a bit "what...?". But I also think it is false to say that EVERY previa is fatal if you don't have a surgical birth. Would I risk my life or my child's in this day and age? No, I would not. But there are cases, both historic and modern, of women delivering vaginally, with previa, where both mom and baby survived. There are degrees of previa, and I can see where a marginal previa could cause greater than normal bleeding but otherwise not harm mom or baby. Complete previa, obviously, is another kettle of fish.

[kate3]

I've worked in OB for over 20 years, many of those spent in high risk OB. I've seen many variations of previa. Here are my thoughts:

At almost 32 weeks it is doubtful that a compete previa will resolve and a vaginal delivery will be safe. Not impossible, but unlikely. I know that's not what you want to hear. Definitely have a f/u sono, but don't hang all your hopes on it.

Just like MeepyCat, I am not impressed by that acupuncture site. It seems very unprofessional and misleading. A complete previa absolutely precludes vaginal delivery, and bleeding with a previa is considered an obstetrical emergency. Acupuncture is fine in pregnancy and certainly worth a try, but I don't like the wording and have not seen evidence that it has any effect on placental position (unlike morning sickness, pain, etc where acupuncture seems to be beneficial).

I know that historically women with complete previa have delivered vaginally, especially prior to ultrasound. But those cases rarely end well. Sorry you are having to deal with this!

[Smokering]

Just like MeepyCat, I am not impressed by that acupuncture site. It seems very unprofessional and misleading. A complete previa absolutely precludes vaginal delivery, and bleeding with a previa is considered an obstetrical emergency.

I have to agree with that. My mother had an undiagnosed placenta previa with my little sister, thanks to dodgy out-in-the-wops prenatal care. It ruptured, she haemmorhaged, she had to have an emergency C-section and my sister was born grey. Not a fun time. Obviously that's just one experience, but it definitely makes me cringe to read that previa "might" cause bleeding. How could it not?

That said, I really hope yours scoots out of the way - what a horrid situation to be in. Good luck!

[MeepyCat]

Originally Posted by karen1968

But I also think it is false to say that EVERY previa is fatal if you don't have a surgical birth. Would I risk my life or my child's in this day and age? No, I would not. But there are cases, both historic and modern, of women delivering vaginally, with previa, where both mom and baby survived. There are degrees of previa, and I can see where a marginal previa could cause greater than normal bleeding but otherwise not harm mom or baby. Complete previa, obviously, is another kettle of fish.

Karen, I'm sorry, but the cases where mom and baby survived vaginal delivery with previa were miracles. Without surgical delivery, roughly half of women with placenta previa would die, and very nearly all of their infants would die as well. I have seen some of the accounts you're talking about - Ina May Gaskin got lucky one time, and if you ask me, Gloria LeMay is a tad off the deep end (and that woman won the obstetrical luck lottery). These accounts describe great good fortune. Had they not proceeded along such miraculous lines, no amount of skill could have prevented fatalities.

Descriptions of the pre-surgical methods for deliveries involving previa are quite frank about the likelihood that the baby will die as a result of the techniques used. It would be unwise to plan on miracles, and irresponsible for a medical professional of any kind to fail to make plans to avoid the risk.

I'm so sorry you're going through this - I was in your shoes last year. I was totally unable to face up to the possibility of surgery until I was practically on the operating table. If I wish anything, I wish I had been able to deal concretely with that possibility earlier.

I hope that your placenta moves. It would be the best of all possible things. But you should give some thought to planning in case it doesn't.

[sweetsadie77]

If it hasn't been done, insist on a transvaginal scan to confirm placental location before any decisions are made on mode of delivery. Transabdominal scans are not accurate on diagnosing previa or in measuring distance from the os with a low lying placenta.

[karen1968]

I think you guys are misreading some of what I'm saying, and I wish I had posted something other than the first acupuncture site I found when writing that post. I agree that it is not likely the placenta will move, but if there is a chance - any chance - to get it to slide out of the way, I want to try it. I am just not willing to give up yet!

The perinatologist did do a trans-vag to confirm. My placenta is centered high on the anterior wall. It is the thin edge that is covering - just barely - both the anterior and posterior edges of the cervix. It is soooooo close to partial...but it's also exactly where it was at 19 weeks.

Originally Posted by MeepyCat

I hope that your placenta moves. It would be the best of all possible things. But you should give some thought to planning in case it doesn't.

I'm planning for both possibilities right now. Tomorrow is my last appt. with the hb mw. After that I will transfer care, I'm just not sure where yet. I will also be telling my boss that I need to go out on leave as of Nov 1st (EDD is 11/25, so that's much sooner than planned). I've been doing some research/thinking about the best c-sec plan for me, my baby, and our situation. In the meantime, I have an appt. With my acupuncturist on Thurs to see what her opinion is. If nothing else, it helps me emotionally to be proactive.

This is my last pregnancy, last baby, last birth. I'm nearly 42, I've had two losses, and last pregnancy ended in an induction due to pre-e. I was really looking forward to having this baby girl at home. It is this loss that I grieve the most right now. I also know this is EXACTLY the time to be grateful for modern medicine and the safety it brings to scary situations.

[Smokering]

I'm nearly 42, I've had two losses, and last pregnancy ended in an induction due to pre-e. I was really looking forward to having this baby girl at home. It is this loss that I grieve the most right now.

I'm so sorry. I lost a homebirth to pre-e too - it really really sucks. I remember texting my sister the news that I was going to be induced from my hospital bed, and being furious when she replied with a chirpy "Ooh, that's exciting!". SO not what I was feeling right then.

I think there are some good threads around here about preparing for as gentle and "birthy" a C-section as possible. If you think you could stand to read them, there's some good advice about skin-to-skin and all that jazz.

[CookAMH]

I'm so sorry you are facing this, especially with all you hoped for with this birth! . I do agree that there are some great threads around on preparing for and having a good c/s experience, especially with the moments immediately following birth (nursing on the operating table, no separation, etc).

[jkpmomtoboys]

I am so sorry you are facing this...

But I am so glad you have had an unremarkable previa pregnancy. You are one of the lucky ones (even though it doesn't feel like it).

I had complete previa, diagnosed via u/s at 20 weeks, first bleed at 24 weeks, home bedrest, second bleed at 28 weeks, hospital bedrest, abruption and hemmorahge at 29 weeks, 5 days. Crash c/s (which is not an emergency c/s), general anesthesia (which means you are totally out), and 50 days in the NICU.

Not pretty.

So I'm not saying this to scare you but just so that you are aware that everything you are doing (pelvic rest, etc...) is to give your baby as much time as possible in utero. I did all of those things and crashed nonetheless. No one knows for sure how to minimize the effects from previa but you are doing everything right.

Good luck...previa sucks mightily...

[karen1968]

Jen. I'm so sorry you had to go through that. I know I am one of the lucky ones, relatively speaking. Although it is "complete" in the sense that the cervical opening us completely covered, it is just the very edge if the placenta doing the covering. I think that's why I haven't had any bleeds. And I'm not technically ON pelvic rest (although it's been a month or more that I've wanted to dtd), I still chase my pre-schooler around, I still do Pilates reformer every week, I still pick up my 31-pound kid. So, yes, in the world of previa patients I've been very lucky. And maybe that's why I'm so reluctant to give in to a c-section until the last possible moment. I'm putting my faith into acupuncture while simultaneously creating a "gentle c-section" birth plan.