Posterior complete placenta previa - what are my odds?

[purplestraws]

At my 19 week ultrasound they suspected a marginal previa on the abdominal scan and then after emptying my bladder we found a complete previa on the transvaginal scan.  My OB seems fairly optimistic that it should resolve, but everything I've read makes it seem like I'm in the worst category for it resolving - posterior location, previous c-section, and complete previa.  The doctor did say that it seemed that the center of the placenta was not covering the os, just the edge of the placenta which gives me better odds.  However, most of what I'm reading says a posterior placenta  previa (especially when it's complete) is a lot less likely to resolve on it's own.  I'm going for a level II scan at the perinatologist next week so they can get a closer look since it did look like it might be marginal in the abdominal scan. 

I really want my VBAC!  Has anyone else been here and had a successful outcome??

[MeepyCat]

I have only sort of been where you are - complete placenta previa at mid-pregnancy u/s.  Mine didn't resolve (I delivered early), but that doesn't mean that yours won't.  You have a lot of time.  IMO, the thing with previas like this is to try and wait them out.  Even though this one is posterior, it is likely to move up and out of the way.  You just need to stay pregnant until then. 

Get the next ultrasound, discuss pelvic rest, and ten weeks from now, if the placenta hasn't gone anywhere, or if you start bleeding, then worry.

[MamaChef]

Vaginal is alot better indicator.  http://www.image-learning.com.ar/comunidadesp/file/123-126%20PLACENTA%20PREVIA.pdf

If the placenta is overlying the cervix then the chances are less that it will resolve.  If it is not overlying the cervix, then the chances are really good.  It's a huge positive that it is posterior.

Rooting for your placenta to move move move!

[purplestraws]

Originally Posted by MamaChef 

Vaginal is alot better indicator.  http://www.image-learning.com.ar/comunidadesp/file/123-126%20PLACENTA%20PREVIA.pdf

If the placenta is overlying the cervix then the chances are less that it will resolve.  If it is not overlying the cervix, then the chances are really good.  It's a huge positive that it is posterior.

Rooting for your placenta to move move move!

Thanks for the link to the study!  I also want to make sure that they check for vasa previa (I would assume they would at a level II scan with the peri?) and my doctor LOVES studies, so this is good information to have on hand. 

I've read, though, that posterior is less likely to resolve because that portion of the uterus isn't going to grow as much as the anterior does??

Thanks for rooting for my placenta. :)
 

[MamaChef]

The level 2 will most definitely check for that. 

That is true.  In general the uterus doesnt grown from back to front as much as front to back..  BUT.. you only need it to grow 1-2cm.  the length of one to two of your fingertips.  If you think about how much more your uterus is going to grow through the rest of your pregnancy, it is completely possible for that to happen. The scar tissue on the front of your uterus might even work to your favor in requiring more slack from the posterior.

Another study

Ultrasound Obstet Gynecol. 2001 Aug;18(2):100-2.

Comment in:
Ultrasound Obstet Gynecol. 2001 Aug;18(2):96-9.

Diagnosis of low-lying placenta: can migration in the third trimester predict
outcome?

Oppenheimer L, Holmes P, Simpson N, Dabrowski A.

Division of Maternal-Fetal Medicine, Ottawa Hospital, General Campus 501 Smyth,
University of Ottawa, Ontario, Canada K1H 8L6. [e-mail]

OBJECTIVES: To investigate the relationship between the rate of migration of a
low-lying placenta during the third trimester and the eventual route of
delivery. METHODS: All patients with a placenta lying within 3 cm of the
internal cervical os or overlapping it on transvaginal ultrasound at > or = 26
weeks' gestation were included in the study. The exact distance between the
center of the internal cervical os and the leading edge of the placenta was
measured by transvaginal sonography, repeated at approximately 4-week intervals
until delivery. RESULTS: The mean rates of migration in patients who had (n = 7)
and who did not have (n = 29) Cesarean section for placenta previa were +0.3
mm/week and +5.4 mm/week, respectively (P < 0.0001). When the placental edge was
initially > 20 mm from the internal os, migration occurred in all cases and no
Cesarean section for placenta previa was performed. For those between -20 mm and
+20 mm, sufficient migration to avoid Cesarean section occurred in 88.5% of
cases. Beyond a 20 mm overlap, significant placental migration did not occur and
all patients required Cesarean section. CONCLUSION: Placental migration may
occur progressively throughout the third trimester. The initial position of the
placental edge and the subsequent rate of migration can be used to predict the
eventual route of delivery.

This is absolutely not proven by any study just my own personal intuition so take it with a grain of salt, but *I* would develop a love for forward leaning postures ASAP :)  I'd also investigate things that would bring more bloodflow and growth to my uterus, like acupuncture.  The uterine arteries supply the blood flow to the lower uterine segment and cervix and the ovarian arteries to the fundus.

[Lillitu]

I had a complete anterior previa at 19 weeks. The way it was implanted, the doctors did not give me much hope. I don't know what your belief system is, but I did alternative treatments and had my religious community pray and do magick for me. I was told to prepare for a C section, and I really wanted a VBAC.

Guess what? It completely rectified itself. I delivered vaginally. I found emotionally for me, I need to plan for plan A (vaginal birth, what I was shooting for) and plan B (C section). I went to natural childbirth classes and created a birth plan that talked a lot about hospitals and interventions, even though I was working with a midwife and a birth center, just in case.

[livinzoo]

I had a complete anterior previa at 19 weeks.  At 27 it was .7mm away from the opening,  At 32 it was .8mm away.  Finally at 37 weeks it was 2.5cm and at 39 it was 3.5.  My placenta went from my ribs to my cervix almost straight down the center of the belly.  They always commented at how long it was.