Likelihood of placenta previa with no symptoms at all? - Mothering Forums

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Old 04-15-2012, 11:42 AM - Thread Starter
 
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I'm 34 weeks and had some minor spotting last night (stopped almost immediately).  Midwife examined me and is "99% sure" that it's nothing serious, but is recommending an ultrasound to check for placenta previa, just in case.  We're planning a homebirth, and have declined ultrasounds so far.

 

My general understanding was that complete previa would just about always cause heavy, painless bleeding either late in the 3rd trimester or in early labor... but now I'm not sure that's the case. I've ran into a few mentions of "asymptomatic previa", but I can't find any research on the rates/likelihood of that. Any ideas?

 

We'd prefer not to do the ultrasound now if the risk is infintesimal (we're under 10 min from the hospital), but I also don't want to take a significant, unnecessary risk.

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Old 04-15-2012, 03:34 PM
 
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Has she used a handheld doppler or fetoscope to listen for placenta sounds to help ascertain where it is?  You can at the very least get a good feeling of high or low to know if you should take the next step to a sono.


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Old 04-15-2012, 03:51 PM - Thread Starter
 
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I don't think she's ever specifically talked about listening for the placenta, but has several times mentioned that she thinks it's attached on the anterior wall just above my hipbone when listening with fetalscope. That's where I can hear my pulse most loudly as well. Is the idea that if the placenta is attached above a certain height, previa is less likely?

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Old 04-15-2012, 05:09 PM
 
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It's not uncommon to be asymptomatic. One small study found about 50% of women had no symptoms. At 34 weeks, if you do have a placenta praevia, it is unlikely to resolve. About 75% of praevias at 35 weeks will still be present at term.

Auscultating the placenta will be of limited value IMO. Unless it is very clearly a fundal insertion you still won't know where the margins are and you could still have a partial overlie of the internal os.

I think this is one of the circumstances in which ultrasound is particularly useful. It has a good chance of providing an accurate diagnosis and the results are likely to impact your birth plans.

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Old 04-15-2012, 05:32 PM
 
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Quote:
Originally Posted by katelove View Post

It's not uncommon to be asymptomatic. One small study found about 50% of women had no symptoms. At 34 weeks, if you do have a placenta praevia, it is unlikely to resolve. About 75% of praevias at 35 weeks will still be present at term.
Auscultating the placenta will be of limited value IMO. Unless it is very clearly a fundal insertion you still won't know where the margins are and you could still have a partial overlie of the internal os.
I think this is one of the circumstances in which ultrasound is particularly useful. It has a good chance of providing an accurate diagnosis and the results are likely to impact your birth plans.


Agreed!


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Old 04-16-2012, 07:11 PM
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This is one of the classic things that is easily diagnosed by a quick us that might otherwise be hidden until it's a crisis.

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Old 04-17-2012, 10:15 AM
 
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It is so much better to get previa diagnosed *before* you get to heavy bleeding. 

 

I had complete previa (resulting in c/s at 32 weeks).  I was diagnosed by routine mid-pregnancy ultrasound, but the first external indication of a problem was small amounts of bleeding at 26 weeks.  I don't think it matters what the odds are of placenta previa having no symptoms, because the small bleed you're talking about is potentially symptom of placenta previa.  An ultrasound could completely resolve this question, and give you immense peace of mind, or valuable time to plan.

 

I have this speech I give sometimes about bleeding, about how they tell you that you should be worried if you're getting through more than a pad or two in an hour, and that makes it sound like hemorrhage is a thing that takes an hour to happen.  With previa, hemorrhage can happen really fast.  I overflowed my heavy duty pad as soon as I put it in.  A hospital ten minutes away is not close enough for the kind of bleeding you'd experience if you went into labor, or even had just a few centimeters of cervical dilation, with the placenta covering the cervical os.

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Old 04-17-2012, 07:33 PM
 
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http://www.infoocean.info/avatar3.jpgYou can at the very least get a good feeling of high or low to know if you should take the next step to a sono.

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