early placenta previa, no vaginal bleeding

A friend has been told at about 10 weeks that her placenta is currently
over the cervix, she has been reassured it will almost certainly move,
but is finding the "no sex" thing rather hard, particularly as she can't
back it up with any information. She's had these scans because it's an
IVF pregnancy (and a difficult to achieve one, they couldn't get any
eggs to ripen for ages), but she's never had any vaginal bleeding. Are
these restrictions really necessary?

Cheers
Anne (mother)

Anne Rogers wrote:
A friend has been told at about 10 weeks that her placenta is currently
over the cervix, she has been reassured it will almost certainly move,
but is finding the "no sex" thing rather hard, particularly as she can't
back it up with any information. She's had these scans because it's an
IVF pregnancy (and a difficult to achieve one, they couldn't get any
eggs to ripen for ages), but she's never had any vaginal bleeding. Are
these restrictions really necessary?

I think there's little basis to know. The vast majority of
women wouldn't even know there was a potential issue at this point
in the pregnancy. I'd say the recommendations are more likely an
abundance of caution rather than a recommendation based on concrete
evidence of risk, but the bummer is that there isn't evidence of
safety either. Under the circumstances, she just has to decide how
cautious she feels she wants to be :-/

Best wishes,
Ericka

turns out it was actually a natural pregnancy that had been thought
impossible, discovered by the requirement to do a pregnancy test before
the first shot, but the IVF clinic then monitored it as they normally
would. She's well aware that this simply wouldn't have been discovered
under normal circumstances, but I don't think is quite able to take the
step of saying to the OB "I've considered your advice and decided to
ignore it".

Anne

Anne Rogers wrote:
turns out it was actually a natural pregnancy that had been thought
impossible, discovered by the requirement to do a pregnancy test before
the first shot, but the IVF clinic then monitored it as they normally
would. She's well aware that this simply wouldn't have been discovered
under normal circumstances, but I don't think is quite able to take the
step of saying to the OB "I've considered your advice and decided to
ignore it".

I rather doubt she's going to find any information that
will make her feel comfortable ignoring the OB's advice.

Best wishes,
Ericka

I rather doubt she's going to find any information that
will make her feel comfortable ignoring the OB's advice.

nor anything that proves it either, which means you end up stuck between
a rock and a hard place. The way I understand things, for her, it's more
than just a frustration to be dealt with, but something that is very
fundamental to her, I'm just crossing my fingers that the anomoly scan
which can't be too far away now will give her the all clear and she'll
be past the worries.

Anne

Anne Rogers wrote:
A friend has been told at about 10 weeks that her placenta is currently
over the cervix, she has been reassured it will almost certainly move,
but is finding the "no sex" thing rather hard, particularly as she can't
back it up with any information. She's had these scans because it's an
IVF pregnancy (and a difficult to achieve one, they couldn't get any
eggs to ripen for ages), but she's never had any vaginal bleeding. Are
these restrictions really necessary?

Cheers
Anne (mother)

Hi Anne,

Having had a placenta previa birth almost 30 years ago and giving birth
to a still born I would suggest that she do whatever they tell her.Mine
was not picked up prior to the birth as there was no such thing as scans.
But tell her not to panic as my still birth was due to incompetent
hospital staff who handled the whole thing rather badly before they
finally rang my OB. I nearly died and had to be given transfusions due
to the amount of blood I lost. I had to have a C section once it was
realized that the baby had died.
My case was added to the emergency manuals as a "what NOT to do in an OB
emergency in the ER"."
For starters... when we got there and rang the night bell it was nearly
5 minutes before we even got into the hospital. Then I had to walk in,
then walk to the bed after they took all my details. Then I should have
been given meds to try to stop the contractions, I wasnt. Whatever it
was that they did give wasnt enough. I was then asked to walk AGAIN to
another part of the ER and by the time they decided to ring the OB it
was too late. By that time I was pretty much losing connection with
reality but well remember my OB totally freaking out when she arrived
and saw the mess I was in. By then the baby was dead as I had been
bleeding and contracting for almost 2 and a half hours.It was 2 days
before I woke up and found out what had happened.

My next two babies were born by C section and taken two weeks before the
due date. When I has having my third child we asked if I could deliver
her naturally as at that stage she was to be the last. My OB said that
if I went into labour prior to the date scheduled for the CS that we
could try. But obviously I could end up in an emergency CS if anything
went wrong meaning that I couldnt have the epidural and be awake.
Well I did get the start of contractions prior to the due date(2 days)
but they stopped.During the CS the doctor asked me if anything unusual
had happened. I told of the mild contracting but that they had stopped
after about an hour...no pain except a strange ripping feeling near my
naval. He told me that it was just as well as I had been bleeding and it
looked like I was previa again. Thank goodness the contractions had stopped.
My last baby was born by CS with no complications.

Tell her it may be hard to abstain from sez but I would follow
instructions at this point. There are other ways to relieve the urge
without penetration......

Her OB isn't telling her to refrain from intercourse for nothing -
anything that disrupts the placenta, such as intercourse or even an
exam of the vagina and cervix may cause bleeding. I wouldn't consider
this to be stuck between a rock and a hard place at all... she has a
potentially serious complication that could harm her and the baby and
she wants to question the advice from her doctor? I fully understand
the frustration of not being to have intercourse for an unknown amount
of time, I was advised not to have sex for a certain time period early
in my second pregnancy - intercourse is a huge part of my and hubby's
life... not to get too personal but it is something that occurs
multiple times on a daily basis with us. So yea it was tough, but
nothing was more important than the safety of the pregnancy and while
we waited it out we enjoyed other things... granted it wasn't the same
but thats it, we had to suck it up. Though I would think that she
would have to avoid orgasms as well as they may start contractions,
which would, in turn disturbs the placenta. Its easy to say that if
this had of been an ordinary pregnancy that she wouldn't be aware of
the problem right now anyway, and while that is true, maybe she would
miscarry at 12 weeks too because no one knew of the issue and she
carried on as normal. The point is that they do know of the problem
and the doctor wants her to take certain precautions. Sorry if this is
coming off bitchy, but I mean really, I would think that this would be
a no brainer, especially for someone who was having fertility
problems.

-Jen

Tell her it may be hard to abstain from sez but I would follow
instructions at this point. There are other ways to relieve the urge
without penetration......

Well she's been told pelvic rest, so that's not allowed either. Placenta
Previa is very serious in 3rd trimester, but realistically cannot be
diagnosed accurately before then either, an awful lot of cases can be
discounted if transvaginal ultrasound is done rather than abdominal, but
transvaginal ultrasound seems under used, leaving lots of women
waiting anxiously to 34ish weeks when well over 90% will be told their
previously low lieing placenta is normally positioned. Your story is
very sad, but as far as I can tell the catastrophic events were near
term, not early in the 2nd trimester. I won't be telling her to go
against doctors orders, just crossing my fingers it's resolved on the
next scan, I feel anxious for her because I'm aware of many things that
make this more difficult for her than most.

Cheers
Anne

Sorry if this is
coming off bitchy, but I mean really, I would think that this would be
a no brainer, especially for someone who was having fertility
problems.

show us the evidence then? seriously, she's a thinking person, I think
she accepts that she's not going to get evidence that tells her it's ok,
but she'd like at least some evidence that shows her it isn't. I'm not
even sure that there is evidence that sex should be avoided with a low
lieing placenta found at 20 or so weeks. I had a look at the NICE
guidelines for antenatal care, which are fairly new and evidence based.
When no symptoms are present, they give no recommendation for pelvic
rest (which she is on, btw, not just no sex). I think she realises (as
do I) the need for caution, but early scans for placenta previa are so
unreliable the chances of this actually being one at term are very slim
- I think it would be a comfort to her if it was clear that IF it truely
is placenta previa, then this would definitely be the right thing, even
if the chance it truely is is fairly low, but as far as I can tell, not
even that is clear.

Cheers
Anne

That could be a long hard wait. :-) The placenta previa was noted at
10 weeks. How many weeks along is she now? The fetal "anatomy" scan
normally would be around 20 weeks.

It may help to keep in mind that the order for pelvic rest is coming
from an IVF clinic, not an ordinary OB clinic. I would expect a "take
no chances, none, nope, no, not at all, negatory" approach from an IVF
clinic. Is pelvic rest normally recommended for 1st trimester
placenta previa? And according to what evidence? Those are the
questions needing answers, right?. There may be no answers but ...
don't a lot of women get early "dating" scans? Wouldn't those scans
include a quick look at the placenta?

Pologirl