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#1
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Complete Placenta Previa
Just diagnosed with a complete placenta previa in my 3rd pregnancy at
my 20/21 week ultrasound. I haven't (to the ustech's amazement) had any bleeding. I am already prone to preterm labor (and in the higher risk category) and my doctor looked confused when I mentioned the previa to him after the ultrasound. Guess the tech didn't tell him. I didn't realize that it could mean more than a C section until I got home (after stopping at Target and carrying my 20 month old around on my hip for 1.5 hours.) No mention of restrictions or possible bleeding or anything. Should I make some lifestyle adjustments (ie not lifting the 20 month old or the 3.5 year old and not carrying the laundry upstairs)? It is Friday, well after 5, and I can't talk to an OB until Monday at the earliest. Thanks! |
#2
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Complete Placenta Previa
Just diagnosed with a complete placenta previa in my 3rd pregnancy at
my 20/21 week ultrasound. I haven't (to the ustech's amazement) had any bleeding. I am already prone to preterm labor (and in the higher risk category) and my doctor looked confused when I mentioned the previa to him after the ultrasound. Guess the tech didn't tell him. I didn't realize that it could mean more than a C section until I got home (after stopping at Target and carrying my 20 month old around on my hip for 1.5 hours.) No mention of restrictions or possible bleeding or anything. Should I make some lifestyle adjustments (ie not lifting the 20 month old or the 3.5 year old and not carrying the laundry upstairs)? It is Friday, well after 5, and I can't talk to an OB until Monday at the earliest. did the tech definitely say complete? it may be that the reason it wasn't immediately flagged to the OB was that it isn't complete? I hope someone else replies, but I think just right now, when there is no bleeding and hasn't been any, that you just carry on as normal. Cheers Anne |
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Complete Placenta Previa
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#4
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Complete Placenta Previa
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#5
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Complete Placenta Previa
I guess I have some trust issues about the OB and his practice
policies. The placenta was truly completely covering the birth canal. I asked the tech just to be sure of what I was seeing after she asked me about the spotting or bleeding. I asked how much was covered and she said that it was completely covered and it's between the middle of placenta and the end on one side, closer to the middle. I asked my OB about it during my appt., he didn't even acknowledge that I had asked. He didn't even say "Oh, it might move," or "Well, we'll see at the next ultrasound." In fact, he didn't mention a next ultrasound, the ultrasound tech said that they would want to do another at 28 weeks to see if it had moved out of the way or not. My husband (who was with me) and I both weren't terribly alarmed, until we found out what "complete placenta previa" meant. This is our 3rd baby, we don't rattle so easily (preterm labor/premature birth with the other two), but the ultrasound tech was slightly alarmed and rattled about it. When I got home, I read up and found out that most OB's would have started suggesting activity limitations as it appears with complete previa that you are more likely to bleed in the second half of the pregnancy. I asked the tech at the time what the chances of this resolving itself were and she said it could happen. Upon reading, it looks like it could, but is less likely than if it had been found before 20 weeks or if it wasn't complete. Premature delivery/labor is likely if bleeding starts. I doubt that there is much in the way of miscommunicating with my OB as there has been really no communicating about it or other issues (high blood glucose); I have doubts as to whether or not he even really looks at the charts before he enters the room. I had also lost 5 lbs last visit; this visit I asked about my weight and he was confused about that as well (this is the ONLY guy I have seen) and referred to the first page of the chart. I had gained back 3 lbs. I was already going to change OB's as I am going to have to move in with my mom (yipee) since my hubby travels 50% of the time for work and with my history of preterm and being 2 hours from any family, but I may make that move a little earlier than the May 20th date I had planned because of this if I need to make changes in my lifestyle (I can't really be home alone with the two kids under 4 and not lift heavy items like children, groceries, and overflowing laundry baskets since we live in a 2 story house.) I just wish he had given me some direction. On Monday, I guess I need to call an OB and ask for clarification about what I should and shouldn't do, but I am not sure if I should bother calling these guys. The last time I called, I was having major cramping (and after a 37 hour labor with my first when I say major cramping, I mean it) and I called after it didn't resolve for 9 hours of laying on my left side and drinking water. They told me "take it easy and call us in the morning." And were nasty because I had called them after hours, even though I called during regular hours the first time and they hadn't returned my call in two hours. I am not sure they would even look at my chart if I called. I do have to get my records to go to the new OB, should I transfer out right away and get to the other people dragging my chart with me? |
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Complete Placenta Previa
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#7
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Complete Placenta Previa
Previa is notoriously overdiagnosed in early ultrasounds. Many, many
times what appears to be a previa in a 16-20 week ultrasound turns out not to be a previa on a 28-32 week ultrasound. I am surprised that the sonographer who did your scan had this reaction, as the phenomenon of the "disappearing previa" is very well known to everyone in the obstetrics world. Of "previas" seen at 16-20 weeks, the vast majority do resolve by the time it matters. Some people would recommend that you avoid sex or sexual stimulation for the time being. You should also, obviously, report any bleeding or contractions immediately. You will have follow up ultrasounds every 4 weeks or so to recheck the placenta location. What do you mean by "prone to preterm labor?" Were your previous babies delivered term or preterm? Was this ultrasound done vaginally or abdominally? It usually isn't possible to define the relationship between the placental location and the cervix abdominally. Also, a vaginal ultrasound would allow measurement of your cervix. This would help to quantify your real risk of preterm labor. |
#8
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Complete Placenta Previa
alath wrote: Previa is notoriously overdiagnosed in early ultrasounds. [...] Yes. But the OB should have been able and willing to explain all this to Tracy during the scheduled appointment. This OB strikes me as the kind of physician who works hard at making his job easier by "avoiding" any patient who has anything other than a textbook normal pregnancy. The purpose of this behavior is to encourage the patient to switch to another provider and take all her potential medical problems away with her. Such a physician will have great statistics, which is one major reason why statistics are not a very sound basis on which to choose a physician. Referrals from other patients and physicians may be more reliable. |
#9
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Complete Placenta Previa
Thanks for your replies Pologirl and all!
I will run (figuratively) from this practice, not walk. Since I was 20 wks, 6d at my ultrasound, I feel like while it might yet pan out to be a misdiagnosis, he should have at least talked about it to me as it wasn't an early u/s. You're right; he should have at least answered my low key questions, even if it was obvious that I wasn't panicked. It's nice to hear someone putting her finger on something I hadn't thought about, too. I think you hit the nail on the head with the avoidance theory. I am not a textbook normal pregnancy: Pre-eclampsia and premature rupture of the membranes coupled with a 35 week birth with the first, borderline blood sugars and preterm labor at 33 weeks add on a cord wrapped twice around her neck and blood pressures topping 145/95 with the second. Even given all of this, we had always wanted 3 children, and I have been doing so well this pregnancy (aside from the 3 days of cramping in my 19th week- due to minor fall, I finally pieced together.) Blood pressure is great; voluntarily eating the diabetic diet and monitoring my blood sugar as a preventative measure. Ironically, I am not really a worrier and I have a high pain threshold. I flat out missed the labor with my first (don't tell that to the 1st time moms out there, it's probably their worst fear) until my water broke. My best friend is a NICU nurse who worked in a level 3; hearing her stories made me realize that most pregnancies are OK. I would not have thought so much about restrictions except she freaked when I told her that the OB hadn't mentioned it, especially with my history. I actually interviewed 3 out of 4 local OB practices in my area. They are in pitifully short supply here (the media uses the term "crisis"), and this guy's was, believe it or not, the better of the lot. I don't know many people here and none who have had babies recently as we have only lived in this area for 1 year. My first was delivered an hour north of here and my second an hour and a half south of here. I haven't been able to figure out why a physician would not make any mention of the possible bleeding (which, btw, if it wasn't a lot I would have probably ignored as normal-jostled-around bleeding) or probed for any restrictions (move the living room furniture around was on my weekend to do list) that need imposed. When he came into the room, I had my 20 month old dangling upside down from my lap playing ride a horse; you would think that might have raised some questions. Your insight makes it make more sense. I plan on picking up my records, unapologetically, by hand on Monday and faxing them to the new OB. I will also call her office (the nurse there was already wondering why I hadn't had a fasting glucose drawn when I gave her my information over the phone to set up my chart) and talk to them about what, if anything, I should do. Hey, stats makers, given my luck with being the one in *insert large percentage here* should I go ahead and buy my lotto ticket? Trying to keep my sense of humor, Tracy |
#10
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Complete Placenta Previa
Thanks Ericka! I will get on the phone first thing Monday!
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