Marginal anterior placenta previa..

[vegemamato]

I was hoping to ask for some perspective from any of you who may have experience with placenta previa (specifially marginal with an anterior presentation).. 

I went in for a dating U/S yesterday and ended up going home with a quite complicated diagnosis (especially considering that I was planning on dropping prenatal care and going completely unassisted).  Anyway, the radiologist dated me around 16.4 weeks (which is right around what I thought) and he gave me a huge list of possibilities including bed rest, hospitalization at 28 weeks and a cessarian.  I've been doing a lot of research and I am kind of wondering what everyone here thinks. 

Here are my main questions:

It's my understanding that 95% of cases resolve themselves by 28 weeks, but is the percentage less with those who have more children (this is my 4th)? 

Could the placenta move down more to where it is covering the OS (rather than staying in the same position or moving up)?

Do we need to abstain from sexual activity?  (the radiologist didn't say anything about it other that that he would discuss my U/S with my OB and she would give me any instructions at my next appt in three weeks)

Thanks!

[Banana731]

Sorry the hiccup in your plans. have you considered posting this in "I'm pregnant" or B&B? You might get a wider range of experiences with marginal previa in those places.

I hope it resolves and you are able to go ahead with your birth plans!

[MeepyCat]

Vegemamato, I second the suggestion to ask in I'm Pregnant and so on, but I'm one of the people who would answer you there anyway, so here goes...

Descriptions of placenta previa can get really confusing, because words like "complete" and "marginal" can be vague.  Is this a "marginal" previa meaning the placenta is marginal to the cervix, or a marginal previa meaning the margin of the cervix overlies the placenta?  (When I was discussing previa with doctors, I finally gave up on words and switched to using my hands to illustrate - a fist for the cervix, and the other hand for the placenta.  It was much less confusing.)  *Usually*, a marginal previa means that the placenta is close to the cervix, but not over it.  Double check that this was what the radiologist meant.

Anterior presentation in a previa case can be a complication for surgical delivery, but I'm going to encourage you not to worry about that too much right now, for the following reasons:

1.  YES, most cases of placenta previa diagnosed at this stage clear up well before delivery.

2.  NO, the placenta cannot move down further over the cervix.  (As your uterus expands, all the points within your uterus - like the placental implantation site and your cervix - move away from each other.  Imagine if you drew two dots on a balloon and then blew it up - the dots would get further apart as the balloon expanded.)

The course of treatment that the radiologist described to you is quite drastic, and, IMO, pretty unlikely.  It wouldn't be appropriate for the radiologist to put you on pelvic rest or anything like that, but I cannot *imagine* having to wait three weeks to talk to my OB about this issue.  Call on Monday.  Ask if your appointment can be moved up.  Ask these questions in detail, in person, as soon as you can.

I have been there with previa, and done that, and my advice is: 

If you have red panties, put them away for the duration. 

Get a follow-up ultrasound on the best imaging equipment available to you (because placentas don't move toward cervixes, but crappy imaging equipment may produce inaccurate diagnoses). 

Watch your hydration, pee often, and generally keep an eye on anything that might cause contractions. 

Remember that, most of the time, this problem goes away by itself. 

Unless you start to bleed (in which case, get to the hospital immediately), get a follow-up in ten weeks or so and don't worry until then.

[chinupchamp]

Originally Posted by MeepyCat 

Vegemamato, I second the suggestion to ask in I'm Pregnant and so on, but I'm one of the people who would answer you there anyway, so here goes...

Descriptions of placenta previa can get really confusing, because words like "complete" and "marginal" can be vague.  Is this a "marginal" previa meaning the placenta is marginal to the cervix, or a marginal previa meaning the margin of the cervix overlies the placenta?  (When I was discussing previa with doctors, I finally gave up on words and switched to using my hands to illustrate - a fist for the cervix, and the other hand for the placenta.  It was much less confusing.)  *Usually*, a marginal previa means that the placenta is close to the cervix, but not over it.  Double check that this was what the radiologist meant.

Anterior presentation in a previa case can be a complication for surgical delivery, but I'm going to encourage you not to worry about that too much right now, for the following reasons:

1.  YES, most cases of placenta previa diagnosed at this stage clear up well before delivery.

2.  NO, the placenta cannot move down further over the cervix.  (As your uterus expands, all the points within your uterus - like the placental implantation site and your cervix - move away from each other.  Imagine if you drew two dots on a balloon and then blew it up - the dots would get further apart as the balloon expanded.)

The course of treatment that the radiologist described to you is quite drastic, and, IMO, pretty unlikely.  It wouldn't be appropriate for the radiologist to put you on pelvic rest or anything like that, but I cannot *imagine* having to wait three weeks to talk to my OB about this issue.  Call on Monday.  Ask if your appointment can be moved up.  Ask these questions in detail, in person, as soon as you can.

I have been there with previa, and done that, and my advice is: 

If you have red panties, put them away for the duration. 

Get a follow-up ultrasound on the best imaging equipment available to you (because placentas don't move toward cervixes, but crappy imaging equipment may produce inaccurate diagnoses). 

Watch your hydration, pee often, and generally keep an eye on anything that might cause contractions. 

Remember that, most of the time, this problem goes away by itself. 

Unless you start to bleed (in which case, get to the hospital immediately), get a follow-up in ten weeks or so and don't worry until then.

I totally second what Meepy has said here.  These early diagnoses of partial previa, or marginal previa at this point aren't usually all that accurate and cause mothers and fathers a lot of stress.  Go in for the follow-up ultrasound on the best equipment in ten weeks and see what happens then.  Your uterus will pull the placenta up, not farther over the cervix.  

Anyway, Meepy already said all that, so good luck and try not to stress about it too much.  Not yet.  It's so early and your uterus is changing all the time!

Keep us posted at any rate.

[tracymom1]

At my 20-ish (really it was 24 weeks) ultrasound with my 2nd, I showed a marginal previa. The tip of the placenta was overlying the cervix by a tiny bit (maybe 2mm?). By the scan I had at 28 weeks it had completely moved out of the way and all was well. I did not go on complete bedrest, but I was instructed to 'take it easy' and refrain from intercourse.

My first was a c-section and I had a complete previa until 30 weeks with that one (amongst other complications, hence the c-section). Previas DO move - almost always, really. When I worked at an Ob's office, we saw previas all the time and only had a few that were stubborn and did not get out of the way. From my experience, the statistics for having a previa that does not move are inaccurate - I believe that far more of them end up moving out of the way than we think.