placenta previa - what would you do? (x-posted)

[jrabbit]

(cross posting because I could really use some input)

We had the nuchal fold scans at 11 & 15 weeks, all was excellent ... except ... marginal placenta previa. Doc said he was 99% positive it would migrate, no worries ... but no sex! Midwife thought the no sex was extreme, but I never got a chance to discuss that further with him, so we complied. Fast forward to now, 23 weeks. We had planned to have another scan at 24ish weeks to check things. ok, fine ... I was hoping to limit the u/s during this pregnancy, but I'll accept this as a valid reason for another.

well, we're going to visit my mother tomorrow. She's an MD, who doesn't approve of hb (or much of our lifestyle). She arranged for an u/s for each of previous 2 babies, so I kind of expect her to want to do another this time. I don't know for sure, since we haven't talked about it.

BUT, I'm concerned about them seeing previa on the scan. If they do, then I'll never hear the end of it. So, up til last night at 2am, I was sure that I'd just refuse her offer. Now, I'm inclined to think that the previa is probably resolved, so if she wants to see her grandbaby, I should let her. (not to mention, it would mean we could get a 23 week scan for free!)

a little more info: I'm 42. My parents are in excellent health and well-off - they don't interfere with our lives much, even though they don't approve of a lot. We live in Texas, they live in Wisconsin and see the grandkids 2-4 times a year. We're planning to move next spring, and we don't know how that will change the visiting schedule. My in-laws live in Texas, and are way more annoying than my parents, so I'm more inclined to let my mom have simple pleasures if it doesn't interfere too much.

What would YOU do?
thanks
--janis

[imagine21]

I think that you're probably correct about the placenta migrating and so go ahead with the scan. In the event that it hasn't migrated, then you are going to want to know about it and you'll probably need to have another u/s as well. If the placenta ends up covering the cervix, well, not a good thing. Have a wonderful visit with your family.

[wombatclay]

I agree... if you had already planned a scan (and I agree, ruling out a previa for a homebirth makes sense to me) then you're not "losing" anything by giving your parents this.

And if there is a previa, you'll probably want one more u/s closer to 40 weeks so you really shouldn't have to listen to your mom too much... just tell them you're having an u/s at X weeks and will make a decision about birth site/mode once you have that info. Hopefully they'll be happy with that and you could still have a HB if the final scan looks good!

Hope you have a wonderful homebirth!

[Hayes]

Have the scan. I had a PP at my 18 wk scan. At 22 wks, it had moved. The tech said the measurement was 2.5cm from os. ACOG guideline is 2.0cm from os. I had another scan at 28 weeks, to be REALLY sure. Continued migration yielded a 3.2cm from os measurement. The tech did a transvaginal ultrasound to get a really accurate measurement. I would really rather know for certain the placenta was clear than to risk an abruption of that nature. I too am planning a homebirth.

[daileyjoy]

Have the scan. I had PP at 14 weeks, planning a UC had another scan at 22 and then another at 35. It never moved and I needed a C-section. Better safe then sorry.

[jrabbit]

Turns out to have been a non-issue. When she asked, she said she was only interested in finding out the sex of the baby - I said no way - and she never mentioned it again. My "no" answer didn't stop her with previous 2 pregnancies. I think our visit this time was just too short to bother.

thanks for the replies!

[kerikadi]

With no symptoms I would continue having sex and nix the follow up U/S but I'm not a fan of U/S so there you go I don't get the whole Mother scheduling an U/S thing. This is YOUR body, not hers.

[jrabbit]

keri - I had really hoped not to have extra u/s this pregnancy - I have mixed feelings about it. But, I'm older, so we decided to do extra testing ... then when he said he was concerned about the placenta, I got nervous.

As for my MOM, it's just her overbearing pushy nature to want to find a way to be involved *and* in control. Since she only sees us rarely, I think wanting to do an u/s in HER hospital is her attempt to create an intimacy that doesn't really exist AND a way to show off her progeny. But, since none of the important doctors/nurses were really going to be able to see us this time, it wasn't as important to her. It's complicated. But in the grand scheme of things, I had come to terms with it. It's a lot less annoying than being bombarded by the crap that my in-laws insist on. "an extra u/s" versus "princess, disney, commercialism, bad processed food full-of-hfcs and other crap, over-the-top junk presents that we have to lose when they go home, condescending remarks about our lifestyle, complete lack of interest in our needs or choices, etc" hmmmmmmmmmm

turns out, I was all worried over nothing - and now we need to schedule another u/s for our own peace of mind. We want to trust that things will be ok, but there is that nagging question in the back of our minds. And, I'm not willing to risk sex without finding out 'why' the doc said no.

--janis

[wombatclay]

And, I'm not willing to risk sex without finding out 'why' the doc said no.

I'm glad the whole thing turned out to be a non-issue.

In terms of the "pelvic rest"... this may not be the reason in your case, but I had a (temporary) partial previa with dd1. Although the placenta finally moved, I was on "pelvic rest" (ie- no penetration/nothing that would cause *ahem* uterine contractions) for a few months. There were a couple reasons given... one was that penetration could irritate the cervix, causing inflamation or even dilation that could affect the placenta (since the placenta was covering the cervix). There could be bleeding either from the cervix or under the placenta which could be bad for the babe (I had a lot of bleeding off and on). And penetration could lead to a higher risk of infection and with the placenta "right there" the impact could be bigger than normal. All these risks were presented as "uncommon but not unheard of" and my care provider for that pregnancy was a fairly crunchy family practice dr (homebirth friendly, etc).

But your care provider may have had something else in mind. I hope your u/s brings the closure you need!