Low lying placenta / placenta praevia

[BellyBelly]

Does anyone have any stories they would like to share if you have been told you have one of these things? What happened and how did you feel? If you could email me at info@bellybelly.com.au asap or post here. Thanks

[MantaRay]

This pg I was told at the 19wk scan that the placenta was very low and I might need a c-section. I was not happy about this at all, but my ob saw me straight after the scan and assured me that while she would check again at 30wks, she was pretty sure it was high enough to not be a problem. I am currently 29 weeks and see her tomorrow, so am hoping she can reassure me again as it has been on my mind.

BTW she mentioned that it was 5.5cms above the cervix and she would only recommend a c-section if it was less than 3 cms above, and maybe even less. And of course she was pretty sure that this distance would increase as the uterus grew, which it certainly has!!

Fingers crossed! I don't know how I would cope with being told I need a caesarian!!

[skyelar]

Hi Kel,

I was told at 18 weeks that I had a low lying placenta. It was measuring .6cm from the cervix.
The sonographer called in the professor to explain what it all meant which was a bit freaky. They told me they wanted to rescan me at 32 weeks to see if the placenta has moved.
Luckily for me I have monthly (now fortnightly) scans with my Ob & whilst my placenta is still apparently 'low' it as moved & there has been no talk of a c-section. I guess I will find out next week how much it has moved.

Can someone explain to me why some placentas are low? Is it that the egg implants low? This is an ICSI bub so was put back by a Dr does that have anything to do with it? My DD (natural conception) there was no talk of a low lying placenta at all.

[BellyBelly]

A study has just come out that I was reading last night, saying that IVF / ART seems to increase the risk factor of Placenta Praevia due to (I think) the embryos being inserted lower into the uterus to aim for a more successful result? That also combined with higher maternal age and multiple pregnancies, previous caesarean or scarring from things like a curette. The article I have written about it will be live soon, almost done

[skyelar]

Thank Kelly can't wait to read it.

[BellyBelly]

Here's the study details:

IVF pregnancy complication link

Embryos may be placed in a vulnerable position
IVF may increase the risk of a potentially dangerous complication of pregnancy, Norwegian research suggests.
Placenta praevia is a condition in which the placenta covers part or all of the cervix, blocking a baby's passage into the birth canal.

Researchers calculated the risk rose from about three in 1,000 pregnancies in the general population, to 16 in 1,000 for women who had had IVF.

The study of 845,000 cases is detailed in the journal Human Reproduction.

A substantial proportion of the extra risk may be attributable directly to factors relating to the reproduction technology

Dr Liv Bente Romundstad

The study, by a team at St Olavs University Hospital, in Trondheim, also found a three-fold higher risk among mothers who had had two pregnancies, once conceiving naturally and once with assistance through IVF, or ICSI, in which a sperm is injected directly into an egg.

The risk rose from seven in 1,000 births for women who had had two natural conceptions, to 20 in 1,000 births for women who had had one natural conception, and one assisted conception.

The researchers took factors such as the age of the mother into account.

Prematurity

Placenta praevia can cause haemorrhaging in the mother, and increases the risk of a premature birth, and problems during delivery.

Small studies have suggested in the past that placenta praevia is more common after the use of assisted fertility techniques.

The Norwegian study was much larger, considering data on over 845,300 pregnancies.

The researchers believe it is the first time an increased risk of placenta praevia has been directly linked to the reproductive techniques used.

Lead researcher Dr Liv Bente Romundstad focused on the 1,349 women in the study who had conceived spontaneously in one pregnancy and after assisted fertility in the other.

"Regardless of whether it was the first or second pregnancy that was conceived through assisted reproductive technology, we found a nearly three-fold higher risk of placenta praevia.

"This suggests that a substantial proportion of the extra risk may be attributable directly to factors relating to the reproduction technology."

Positioning

The underlying mechanism causing the placenta praevia is not clear.

It is possible that IVF may trigger contractions, leading to embryos implanting lower down the uterus than in natural conceptions.

Alternatively, doctors may position the embryo lower down the uterus in order to improve implantation rates.

The researchers are calling for fertility clinics to record the position of every transferred embryo.

Dr Peter Bromwich, from the Care fertility clinic in Northampton, described the study as "fascinating".

He said: "I have not come across this suggestion before. I already do measure the position of transferred embryos, but I will start to record it too now."

However, he added: "Placenta praevia is a rare condition, and the fact that it might be a little less rare in IVF pregnancies should not be a cause for concern for people having the treatment."

Dr Mark Hamilton, chairman of the British Fertility Society, said: "Patients who are considering IVF treatment should discuss concerns with their gynaecologist in advance of treatment and those who are pregnant might want to discuss this with their obstetrician."

The Human Fertilisation and Embryology Authority said the research would be carefully considered by its Scientific and Clinical Advances Group.

[Jennifer13]

Hi Kelly

As you know (I've already sent you my story in the past, I think?) I had low-lying placenta and ended up having a c/s at 39 wks.

I was a most unusual case as I had none of the 'risk' factors, previous D&C, age, IVF, previous c/s, etc, etc. My ob told me he hadn't seen one that hadn't moved for him in 8 years. Lucky me, to be the exception! At 19 wks it was about 0.5 cm away from the cervix, so pretty close, and it only managed to move another 2 cms to the end of my pg. This could have been because both me and the baby are only small and my fundal height was measuring cms behind my weeks. The fact that the placenta was posterior also probably contributed, as posterior low-lying placentas don't 'move' as much.

Interestingly, up until my final scan at 37 weeks (I requested as much time as possible to have the best chance of a vaginal delivery and was fully supported by my ob) I was never given the impression that a c/s was a certainty, even when the 32 wk scan wasn't promising.

Now I've had a c/s I can only hope next time around I don't have another low-lying placenta and I get my vbac!