Hazel is having a low placenta and she just seen a gynea today. Our normal gynea was not around and she was recommended to go to another gynea for a check up to see if she and baby is fine. Scans are showing that the baby is fine. Baby is now at about 371g and babycenter sg states that at 21 weeks it should be at about 360g. Since he is heavier, I guess it looks ok. However she is given hospitalization leave for bed rest. I am really concerned and worried. Did some search around the net since I could not be present during her visit today and ask the doctor questions.
WALL OF TEXT WARNING!
Quote from Babyworld
Low-lying placentaQuote from bellybellyIn the majority of pregnancies, the placenta forms in the top half of the womb. In some cases, however, it forms in the lower half, so that it lies partly or completely over the cervix, blocking the baby's way out of the womb. This is known as a low-lying placenta (or placenta praevia).
The position of your placenta can be shown by an ultrasound scan. If you have a scan in the first half of your pregnancy that shows that your placenta is low-lying, this isn't usually any cause for concern. As many as one in four placentas may be low-lying in mid-pregnancy. The likelihood is that as your womb gets bigger, the placenta will move up (it doesn't actually 'move' as such, but as the womb grows, the area to which the placenta is attached stretches upwards, away from the cervix). If your placenta is shown to be low-lying in mid-pregnancy, you're likely to be offered another scan later on (usually around 32-34 weeks) to check that it has moved. Only 0.5 per cent -1 per cent of placentas remain low-lying at the end of pregnancy. However, when this happens, it can cause problems.
The main problem that a low-lying placenta can cause is bright red bleeding from the vagina during the later stages of pregnancy. The bleeding may stop and start at first, and is painless. It happens because the lower part of your womb is starting to change shape and thin out in readiness for your baby to be born, but because the placenta can't stretch in the same way, it peels away at the edges, which causes bleeding.
At first, the bleeding is usually slight, but there's a risk that it might become heavy at any time without warning. Heavy bleeding may be accompanied by signs of shock - paleness, sweating and an increased pulse.
If you haven't had a scan that has shown the position of your placenta and you experience this kind of bleeding, it may be an indication that the placenta is low-lying. Another sign that you might have a low-lying placenta is that your baby is lying in an awkward position in your womb - for example from side to side, or at an angle.
Having a low-lying placenta won't in itself harm your baby. If it causes bleeding, the blood comes from the mother, not from the baby, although it's occasionally possible that the baby might lose some blood too. Sometimes, however, if the bleeding is serious, it's necessary to deliver the baby early.
Unless the low-lying placenta causes bleeding, there is nothing that needs to be done about it. However, if you have any bleeding at any time, consult your doctor immediately. If he or she suspects that the bleeding is due to a low-lying placenta, you will be advised to have an ultrasound scan. If the diagnosis is confirmed by the scan, the treatment will depend on exactly where the placenta is lying, how many weeks pregnant you are, and how much bleeding you've had.
If the placenta is lying across the cervix, there's a very high risk that you'll experience more bleeding, which could be extremely heavy and put both you and your baby's lives at risk. Because of this you'll almost certainly be advised to stay in hospital until your baby is born. There's still a possibility that the placenta may move away from the cervix, but this becomes less likely as your pregnancy advances. You may be offered repeated scans to check whether the placenta is moving or not. If it doesn't move, the only way that your baby can be born is by Caesarean. This will usually be carried out at around 38 weeks.
If the placenta is only partly over the cervix, you'll probably still be advised to stay in hospital for the rest of your pregnancy because of the risk that you might bleed at any time. You'll need to discuss with your doctor whether to have the baby normally or by Caesarean. Some doctors will always recommend a Caesarean because of the risk of bleeding with a normal birth.
After an ultrasound, you may be told that you have a low-lying placenta or your placenta may be covering your cervix, meaning the placenta has implanted low down in your uterus. This is reported in around 5% of pregnancies at the 18-20 week scan. There is no need to worry if you are amongst this 5% – you can continue your daily activities as per normal unless you have been advised otherwise.
In your third trimester (until around 36 weeks) the bottom part of your uterus does most of it's growing and stretching, taking the placenta with it. It doesn't 'migrate' upwards, but being attached to the uterine wall, it's carried upwards with it. In 0.5% of cases, the placenta doesn't move up with the uterus – so given that small percent, there is an extremely good chance that your placenta will not be covering your cervix when it's time to give birth, enabling you to have a vaginal birth.
If you have a low lying placenta at 18-20 weeks, this does not mean you need a caesarean section. The placenta will highly likely move as mentioned above. The uterus still has much growing to do, so an ultrasound late in your third trimester will give you and your carer a better picture on what's really going on and if it really is of concern.
Placenta Praevia
Placenta Praevia (which means placenta first) is a rare condition which occurs in around 0.5% of pregnancies. Instead of implanting on the uterine wall, the placenta implants partly or wholly over the cervix.
How Do I Know If I Have Placenta Praevia?
Placenta Praevia is usually detected by ultrasound and/or bleeding in pregnancy. The first bleed most commonly occurs at around 34-38 weeks of pregnancy, but may occur sooner or later than this. It doesn't always lead to pre-term birth, but it is more common. Some women never experience any bleeding at all but any painless blood loss should be reported.
It is important to be reminded that it's the mothers blood which is lost, not the babies. The more centrally the placenta is situated over the cervix, the earlier the haemorrhage and the greater the amount of blood lost.
What Causes Placenta Praevia?
The cause is often unknown and is less common in first pregnancies. Placenta Praevia may be found in multiple pregnancies as a result of a larger surface area of the placenta, or from scarring on the lining of your uterus from a previous caesarean section or curette etc. Some studies have recently shown that those using ART (assisted reproductive technology) to be another possibility for Placenta Praevia. The late implantation of the fertilised ovum i.e. conception late in the cycle, will result in the fertilised ovum settling in lower down the uterine wall than if conception takes place at ovulation where it settles in high up in the uterine cavity. It has also been suggested that doctors are inserting embryos lower in the uterus to aim for higher success rates.
Given that caesarean sections are on the increase, along with ART, this may see an increase in the incidence of Placenta Praevia.
What If I Have Placenta Praevia?
If you have Placenta Praevia, you will likely need to birth your baby by caesarean section depending on the grade or degree of Placenta Praevia. You may be able to birth vaginally if you have a grade 1 or 2 Placenta Praevia, however if you have grades 3 or 4, a caesarean section will be necessary. This wont be booked in immediately, if you don't go into labour before hand, you will likely be booked in at around 38 weeks when your baby is more mature. If you go into labour prior to this you will need an emergency caesarean. A grade 4 Placenta Praevia will often mean being admitted to hospital at the first bleed and remaining as an inpatient until birth.
Some women may find the thought of a caesarean upsetting, not being able to birth their baby vaginally and may feel like their birth will be a failure. However birthing your baby by caesarean is not a failure – it's the safest way (perhaps only way!) to bring your baby into the world and is the safest way for mum too. If you have trouble dealing with your emotions, it's important to seek the help of an experienced psychologist or support groups for caesarean healing.
And many more sites documenting this...
So far, I think I can summarize the following.
- At 21st week, low placenta might not be low later on since there is chances that after the tummy grows, the placenta will move up.
- Need to monitor it
- Avoid LONG durations of standing (darling...see this!!!)
- Be easy on your body, slow movements
I said before that I am not superstitious but it is times like this that it is better to believe than not......
Please bless Hazel and baby to be healthy and let her have a normal enjoyable pregnancy.
