Ultrasound to see where placenta attached? - Mothering Forums

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#1 of 18 Old 07-29-2005, 04:17 PM - Thread Starter
 
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I am planning a HBAC for baby #2 (I'm 12 weeks pregnant). Midwife wants me to have an ultrasound (at around 20-22 weeks) to make sure that the placenta did not attach on my uterine incision/scar (increased risk of rupture).

I'm fine with having the ultrasound, I'm just wondering if this is something that other midwives/CNM's/doctors are checking other VBAC mom's for???

It makes sense to me, though it's not something that I've read about here or elsewhere.

Thanks,
C
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#2 of 18 Old 07-29-2005, 04:44 PM
 
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My ob wanted an ultrasound to make sure the placenta wasn't too close to the scar. Not because of risk of rupture, but apparently, sometimes the placenta can grow into the scar and cause problems. Mine was kinda low, on the front of my uterus (we knew that because we could hear it when trying to find the baby's heartbeat) so it was a real concern. No biggie, the placenta was above the scar and continued to go farther up my uterus as my pregnancy advanced. My midwives weren't too worried about it, said it was up to me if I wanted to have the u/s or not. I went ahead and had it done, just in case, I didn't want to alienate/offend my ob too early on, and because I wanted to save up my bargaining chips in case I had bigger battles to fight.
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#3 of 18 Old 07-29-2005, 10:52 PM
 
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I think that in most routine ultrasounds, they look for placenta location as well, although usually for previa. I know that in my ultrasound reports there is always a note about placenta location. With a C section, as the PP mentioned, there is also increased risk of placenta accreta/percreta. Since I have now had 2 C sections and a UR, my OB specifically mentioned having an early ultrasound to determine placenta location. With each section there is an increased risk of placental issues.

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#4 of 18 Old 07-29-2005, 11:27 PM
 
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At my 20 week u/s, they did check the location of the placenta. I was personally worried about having the placenta attach over the scar b/c of the whole acretia/percretia danger. My placenta is anterior but well above the scar.
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#5 of 18 Old 07-31-2005, 06:07 PM
 
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I had previa at 13 weeks, then at 20 weeks it had moved. But I moved to another state and under this state's guideline for a VBAC, I have to have a 3rd tri ultrasound to check placenta location.

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#6 of 18 Old 07-31-2005, 06:16 PM
 
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It's my understanding that the placenta can move too... So at 20 weeks, there's still a half a pregnancy for things to change.
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#7 of 18 Old 07-31-2005, 09:28 PM
 
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Well, a previa can move. As the uterus expands, it usually moves the placenta up and away from the cervix. But accreta/percreta are conditions where the placenta actually grows into the wall of the uterus and in some cases may actually invade other parts of the abdomen. These are extremely serious conditions. While these complications are rare, they are far more likely in women who have had previous cesareans (or any uterine surgery) since the scar area may provide a location for the placenta to grow into.

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#8 of 18 Old 08-01-2005, 02:03 AM
 
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Yes, on all ultrasound scans the placenta is located and noted...however, since you have had previous surgery on your uterus, you should know that the placenta has a better than normal chance of anchoring on the caesarean scar and causing you problems with future pregnancies, including this one.

They did not tell you that when you agreed to the first caesarean delivery, did they?

It is called informed consent.

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#9 of 18 Old 08-01-2005, 05:40 PM
 
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My HB MW had me get an U/S to make sure my placenta wasn't near the scar b/c of the possibility of placenta accreta. I ended up getting another u/s at 33 wks (at a diff place) b/c the first tech didn't record the necessary info. She just noted that it was anterior.:

My OB for my 1st VBAC didn't ever mention anything about this.
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#10 of 18 Old 10-02-2005, 08:37 PM - Thread Starter
 
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Just wanted to post an update to my original post....had the ultrasound last week and the placenta is NOT attached to the scar!

So now my HB plans can continue (the midwife we are using wouldn't have been able to attend at home if the placenta had been attached to the scar due to her states HB regulations).

Anyway, I am thrilled!
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#11 of 18 Old 10-02-2005, 10:46 PM
 
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Thats great. I hope you have a wonderful birth.
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#12 of 18 Old 10-03-2005, 02:13 AM
 
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Quote:
Originally Posted by MAMom
Just wanted to post an update to my original post....had the ultrasound last week and the placenta is NOT attached to the scar!

So now my HB plans can continue (the midwife we are using wouldn't have been able to attend at home if the placenta had been attached to the scar due to her states HB regulations).

Anyway, I am thrilled!
Great!!
I had my ultrasound a couple of weeks ago, and the placenta is on my back, way up at the top. HB plans all around!
Congrats and good luck!

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#13 of 18 Old 10-03-2005, 04:40 AM
 
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So happy to find this thread... This topic has been on my mind. My MW recommends a 36 wk U/S to check where the placenta is attached, but she did say she would go along with me if I choose not to have the U/S. I am wondering (but haven't yet done any research) what exactly the risk is for placenta implantation problems (accreta, implantation into scar...etc) in women with a previous cesarean scar. I really don't want an ultrasound, and I'm feeling like placenta problems are just another thing to "fear"...like uterine rupture. I am worried that if the placenta was on the borderline of a problem, then it would add undue worry, and may not even BE a problem...just like any other test can cause undue worry. Am I being silly??? I don't think I will feel better about making a decision either way until I know the statistics. Like, how, having a statistic on uterine rupture rate makes me feel better about my decision to have an HBAC. I'm not going to live in fear of a .5% chance of UR. Does anyone have placental-attachment-in-scarred-uterus statistics??
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#14 of 18 Old 10-03-2005, 10:04 AM
 
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Quote:
Originally Posted by Breana
Does anyone have placental-attachment-in-scarred-uterus statistics??
Here is some info from the AAFP:
http://www.aafp.org/afp/990800ap/tips/13.html

http://www.obfocus.com/high-risk/ble...morrhagepa.htm

http://www.findarticles.com/p/articl...37/ai_95792140

Its hard to find info about placenta accreta that does not also discuss placenta previa, since that is the primary risk factor with previous cesareans being a compounding factor.

I know that Henci Goer's books discuss the risks. It was one of the primary drivers for my wanting a VBAC.

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#15 of 18 Old 10-03-2005, 10:09 AM
 
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When I am pregnant again, placental positioning is the only u/s that I am going to ask for at about 30 weeks, just to make sure that I dont have accreta (sp) because a friend of mine had this with her last child, and my instincts are telling me that thats what would be right to do. I think it is pretty common to check for this and other placental problems especially in mums who have had previous c-sections.
I am glad your u/s went well
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#16 of 18 Old 10-06-2005, 09:53 AM
 
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I don't know all the statistics but I do know the risks increase incrementally as the number of c-sections go up. I have another ultrasound this afternoon because they think the placenta is over the cervix (placenta previa) and the risk is 7.4x higher because I've had two c-sections.

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#17 of 18 Old 10-10-2005, 11:23 PM
 
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My doula had to have this done with her second child, too--this is only the second time I've heard of it. Nice to know that it actually does seem to be somewhat routine!
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#18 of 18 Old 10-12-2005, 03:59 PM
 
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I had an appointment with my midwife the other night, and with this question weighing heavily on my mind, I asked her if she thought she could hear the placenta on the doppler yet. I told her DH and I were really leaning away from having a U/S at all. I expected to have to explain myself a little bit, because she had been the one that had brought up the 36 week U/S in the first place, but instead she very supportively reassured us that that was no big deal, that she was sure she'd be able to hear it, that she had done many VBAC's before they ever considered U/Sing for placenta without any problem...etc. There was NO battle! She listened to the baby, got a clear HB low in my uterus, then moved the doppler up to the fundus and explained to us the different sounds coming from the placenta... WE HEARD IT!! I am so relieved...mostly that I don't have to have an ultrasound! I don't know why, and I don't want anyone to think this is a judgement on other's choices, but I just really did not want to have one, unless I felt a compelling reason to do so. And, I wanted to share here, so that if anyone else is feeling the same way I was feeling, my internal conflict has resolved itself, and I'm SO peaceful now.
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