Here she is! All the parts and pieces are there upon initial inspection. She was moving and covering her face. The specialist takes a look next just to verify results. She was more cooperative than Rowan's ultrasound sessions!
We did get a special session with our doctor afterwards after the technician found that we have a complication called placenta previa. We had a minor scare this weekend with some spotting and phone calls to the Dr. on call and this explains that. It's possible that it might resolve itself but chances are better that it won't :( I'm pretty upset about it and dreading worst case scenario of bed rest with a toddler afoot, but let's not put the cart before the horse. At least baby is in good shape and just the right size with a good heart beat.
Here is the run down from my go to info. site, babycenter.com:
What is placenta previa?
If you have placenta previa, it means that your placenta is lying unusually low in your uterus, next to or covering your cervix. The placenta is the pancake-shaped organ – normally located near the top of the uterus – that supplies your baby with nutrients through the umbilical cord.
If you're found to have placenta previa early in pregnancy, it's not usually considered a problem. But if the placenta is still close to the cervix later in pregnancy, it can cause bleeding, which can lead to other complications and may mean that you'll need to deliver early. If you have placenta previa when it's time to deliver your baby, you'll need to have a
cesarean section.
If the placenta covers the cervix completely, it's called a complete or total previa. If it's right on the border of the cervix, it's called a marginal previa. (You may also hear the term "partial previa," which refers to a placenta that covers part of the cervical opening once the cervix starts to dilate.) If the edge of the placenta is within two centimeters of the cervix but not bordering it, it's called a low-lying placenta.
The location of your placenta will be checked during your mid-pregnancy
ultrasound exam (usually done between 16 to 20 weeks) and again later if necessary.
What happens if I'm diagnosed with placenta previa?
It depends on how far along you are in pregnancy. Don't panic if your mid-pregnancy ultrasound shows that you have placenta previa. As your pregnancy progresses, your placenta is likely to "migrate" farther from your cervix and no longer be a problem.
(Since the placenta is implanted in the uterus, it doesn't actually move, but it can end up farther from your cervix as your uterus expands. Also, as the placenta itself grows, it's likely to grow toward the richer blood supply in the upper part of the uterus.)
If placenta previa is seen on your second-trimester ultrasound, you'll have a follow-up ultrasound early in your third trimester to recheck the location of your placenta. If you have any
vaginal bleeding in the meantime, you'll have an ultrasound to find out what's going on.
Only a small percentage of women who have a low-lying placenta or previa detected on an ultrasound before 20 weeks still have it when they deliver their baby. A placenta that completely covers the cervix is more likely to stay that way than one that's bordering it (marginal) or nearby (low-lying). Overall, placenta previa is present in up to 1 in 200 deliveries.
What will happen if my previa persists?
If the follow-up ultrasound reveals that your placenta is still covering or too close to your cervix, you'll be put on "pelvic rest," which means no intercourse or vaginal exams for the rest of your pregnancy. And you'll be advised to take it easy and avoid activities that might provoke vaginal bleeding, such as vigorous exercise or strenuous activity.
When it's time to deliver, you'll need a c-section. With a complete previa, the placenta blocks the baby's way out. And even if the placenta is only bordering the cervix, you'll still need to deliver by c-section in most cases because the placenta can bleed profusely as the cervix dilates.
You're likely to have some painless vaginal bleeding in the third trimester. If you do start bleeding (or if you have contractions), you'll have to be hospitalized. The bleeding happens when your cervix begins to thin out or open up (even a little), which disrupts the blood vessels in that area.
What happens next will depend on how far along you are in your pregnancy, how heavy the bleeding is, and how you and your baby are doing. (By the way, if you have bleeding and you're
Rh-negative, you'll need a shot of Rh immune globulin, unless the baby's father is Rh-negative, too.)
If you're near full-term, your baby will be delivered by c-section right away.
If your baby is still
premature, he'll be delivered immediately if his condition warrants it or if you have heavy bleeding that doesn't stop. Otherwise, you'll be watched in the hospital until the bleeding stops. If you're less than 34 weeks, you may be given
corticosteroids to speed up your baby's lung development and to prevent other complications in case he ends up being delivered prematurely.
If the bleeding stops and you continue to remain free of bleeding for at least a couple of days – and if both you and your baby are in good condition and you have quick access to a hospital should the bleeding start up again – you may be sent home. But it's likely for the bleeding to start again at some point and, if this happens, you'll need to return to the hospital immediately.
If you and your baby continue to do well and you don't need to deliver right away, you'll have a scheduled c-section at around 37 weeks, unless there's a reason to intervene earlier. When making the decision, your medical team will weigh the benefit of giving your baby extra time to mature against the risk of waiting, with the possibility of facing an episode of heavy bleeding and the need for an emergency c-section.
What other complications can placenta previa cause?
Having placenta previa makes it more likely that you'll have heavy bleeding and need a blood transfusion. This is the case not only during pregnancy but also during and after delivery. Here's why:
After a baby is delivered by c-section, the obstetrician delivers the placenta and the mother is given Pitocin (and possibly other medications). Pitocin causes the uterus to contract, which helps stop the bleeding from the area where the placenta was implanted. But when you have placenta previa, the placenta is implanted in the lower part of the uterus, which doesn't contract as well as the upper part – so the contractions aren't as effective at stopping the bleeding.
Women who have placenta previa are also more likely to have a placenta that's implanted too deeply and that doesn't separate easily at delivery. This is called placenta accreta. Placenta accreta can cause massive bleeding and the need for multiple blood transfusions at delivery. It can be life threatening and may require a hysterectomy to control the bleeding.
The incidence of placenta accreta has been on the rise, hand in hand with the rising c-section rate. That's because having a prior c-section makes it more likely that a woman with placenta previa will also have placenta accreta. In fact, the risk goes up dramatically as the number of prior c-sections goes up.
Finally, if you need to deliver before term, your baby will be at risk for complications from
premature birth – such as breathing problems and low birth weight.
Who's most at risk for placenta previa?
Most women who develop placenta previa have no apparent risk factors. But if any of the following apply to you, you're more likely to have this complication:
- You had placenta previa in a previous pregnancy.
- You've had c-sections before. (The more c-sections you've had, the higher the risk.)
- You've had some other uterine surgery (such as a D&C or fibroid removal).
- You're pregnant with twins or more.
- You're a cigarette smoker.
- You use cocaine.
Also, the more babies you've had and the older you are, the higher your risk.
