Anterior Placenta...

hermione76 · March 2012

When I had the ultrasound last week the tech told me I had an anterior placenta. Which is probably why I have not felt her move yet. I asked the doctor if it was a big deal. He paused for a min and told me we would need to do another ultrasound closer to my due date. He said that it's rare but some women that have had a c/s could have more complications with an anterior placenta. It could grow onto the c/s scar tissue and cause problems with the delivery. He said if that was the case no VBAC. I asked what the problems could be and he said that if that happened, I would have to have a total hysterectomy. I know we was telling me worst case. I have been trying really hard not to think about it. I looked at some stuff on Google and most sites say that it is usually no big deal. Anyone else have this brought up?

Harper'smom · March 2012

I have one. I felt movement at 19 weeks and it has been strong ever since. At my 20 week ultrasound the placenta was low, which is normal at that gestation, so my MWs wanted a third tri ultra sound to be sure. At 30 weeks my placenta had moved up and was "fundal anterior" which means it is at the top of my uterus far away from my scar. They gave me the thumbs up. Because your scar is on the anterior side of your uterus a anterior placenta has a elevated risk of growing into the scar. The risks your OB described are serious but only if the placenta attaches in the danger area and a ultrasound will warn of this ahead of time.

Some studies show an increased percentage of posterior babies when an anterior placenta is present but this is debated. My MWs said they don't believe in the correlation. My baby happens to be posterior but we are working on that...

hermione76 · March 2012

He said that we would do another ultrasound in the third-trimester to see what is going on in there. I guess you can't tell at this point? I was a little upset at the appointment and wanted to go home and do some research. I am going to write down the questions I have for him for the next visit. She is butt down at the moment and I hope he decides to turn in the next few months. I know he has plenty of time to flip, and I think I am just got overly worried. I hope that it fixes on it's own and I can still try for a VBAC. The thought of having a hysterectomy at 26 is scary. Does your midwife say they have experienced it before. My doctor said he personally has never had it happen, but the hospital I am delivering at has have more then a few.

Harper'smom:
I have one. I felt movement at 19 weeks and it has been strong ever since. At my 20 week ultrasound the placenta was low, which is normal at that gestation, so my MWs wanted a third tri ultra sound to be sure. At 30 weeks my placenta had moved up and was "fundal anterior" which means it is at the top of my uterus far away from my scar. They gave me the thumbs up. Because your scar is on the anterior side of your uterus a anterior placenta has a elevated risk of growing into the scar. The risks your OB described are serious but only if the placenta attaches in the danger area and a ultrasound will warn of this ahead of time.

Some studies show an increased percentage of posterior babies when an anterior placenta is present but this is debated. My MWs said they don't believe in the correlation. My baby happens to be posterior but we are working on that...

Harper'smom · March 2012

If the MWs were not happy with the ultrasound I would have risked out of their center and my care would have been transferred to an O.B. I don't think any provider would touch a VBAC with a placenta accreta and I wouldn't be comfortable with the risks anyways. The good news is that once your placenta moves up it doesn't go back down. As long as you get that third tri ultrasound confirmation you are good to go in terms of that issue. It isn't a blind risk.

It was frustrating to wait 10 more weeks for the ultrasound. I was already done with my Bradley classes and had pre-paid most of my birth center fees. I just decided to commit to VBAC until there was a medical reason that made it unsafe.

To be clear though...a severe uterine rupture could result in a hysterectomy but those odds are very low and are not limited to VBACs. A RCS could also lead to complications that require a hysterectomy. There is no birth scenario that can exclude all of the risks. You just have to decide which ones you want to worry about and which ones you can influence. I wasn't scared of any risks with my first pregnancy but now that I'm a mom it is easier to worry as there is more on the line. I think this is normal.

hermione76 · March 2012

Thanks for responding. I am just trying not to think about it before we have another ultrasound. I know their are risks for any way we decided to go about this. It just makes it more real when you already have another at home. I am taking a VBAC class next week that I already paid for. I am going to stay positive that I can at least try for a VBAC.

Harper'smom:
If the MWs were not happy with the ultrasound I would have risked out of their center and my care would have been transferred to an O.B. I don't think any provider would touch a VBAC with a placenta accreta and I wouldn't be comfortable with the risks anyways. The good news is that once your placenta moves up it doesn't go back down. As long as you get that third tri ultrasound confirmation you are good to go in terms of that issue. It isn't a blind risk.

It was frustrating to wait 10 more weeks for the ultrasound. I was already done with my Bradley classes and had pre-paid most of my birth center fees. I just decided to commit to VBAC until there was a medical reason that made it unsafe.

To be clear though...a severe uterine rupture could result in a hysterectomy but those odds are very low and are not limited to VBACs. A RCS could also lead to complications that require a hysterectomy. There is no birth scenario that can exclude all of the risks. You just have to decide which ones you want to worry about and which ones you can influence. I wasn't scared of any risks with my first pregnancy but now that I'm a mom it is easier to worry as there is more on the line. I think this is normal.

iris427 · March 2012

Harper'smom:
If the MWs were not happy with the ultrasound I would have risked out of their center and my care would have been transferred to an O.B. I don't think any provider would touch a VBAC with a placenta accreta and I wouldn't be comfortable with the risks anyways. The good news is that once your placenta moves up it doesn't go back down. As long as you get that third tri ultrasound confirmation you are good to go in terms of that issue. It isn't a blind risk.

It was frustrating to wait 10 more weeks for the ultrasound. I was already done with my Bradley classes and had pre-paid most of my birth center fees. I just decided to commit to VBAC until there was a medical reason that made it unsafe.

To be clear though...a severe uterine rupture could result in a hysterectomy but those odds are very low and are not limited to VBACs. A RCS could also lead to complications that require a hysterectomy. There is no birth scenario that can exclude all of the risks. You just have to decide which ones you want to worry about and which ones you can influence. I wasn't scared of any risks with my first pregnancy but now that I'm a mom it is easier to worry as there is more on the line. I think this is normal.

A prior cesarean means you are at higher risk than the general population for placenta accreta, especially if you have a low-lying placenta or placenta previa. But even so, it is pretty rare. It is good that your doctor is on top of this and going to keep an eye on your placenta--you definitely would not want to be surprised with a placenta accreta at delivery. I hope that you get good news at the next ultrasound. Keep us posted.

hermione76 · March 2012

I was glad that he was honest with me when I asked. I was just scared after I got the answer. I am glad that he is still being positive about the VBAC. He said we would keep an eye on it and see what happens. I am anxious for another ultrasound to see what is going on in there. Thank you for the response and kind words.

iris427:
Harper'smom:
If the MWs were not happy with the ultrasound I would have risked out of their center and my care would have been transferred to an O.B. I don't think any provider would touch a VBAC with a placenta accreta and I wouldn't be comfortable with the risks anyways. The good news is that once your placenta moves up it doesn't go back down. As long as you get that third tri ultrasound confirmation you are good to go in terms of that issue. It isn't a blind risk.

It was frustrating to wait 10 more weeks for the ultrasound. I was already done with my Bradley classes and had pre-paid most of my birth center fees. I just decided to commit to VBAC until there was a medical reason that made it unsafe.

To be clear though...a severe uterine rupture could result in a hysterectomy but those odds are very low and are not limited to VBACs. A RCS could also lead to complications that require a hysterectomy. There is no birth scenario that can exclude all of the risks. You just have to decide which ones you want to worry about and which ones you can influence. I wasn't scared of any risks with my first pregnancy but now that I'm a mom it is easier to worry as there is more on the line. I think this is normal.
A prior cesarean means you are at higher risk than the general population for placenta accreta, especially if you have a low-lying placenta or placenta previa. But even so, it is pretty rare. It is good that your doctor is on top of this and going to keep an eye on your placenta--you definitely would not want to be surprised with a placenta accreta at delivery. I hope that you get good news at the next ultrasound. Keep us posted.

hermione76 · March 2012

At what time did your doctor do another ultrasound? My doctor never really said a time. I was just curious.

Harper'smom:
If the MWs were not happy with the ultrasound I would have risked out of their center and my care would have been transferred to an O.B. I don't think any provider would touch a VBAC with a placenta accreta and I wouldn't be comfortable with the risks anyways. The good news is that once your placenta moves up it doesn't go back down. As long as you get that third tri ultrasound confirmation you are good to go in terms of that issue. It isn't a blind risk.

It was frustrating to wait 10 more weeks for the ultrasound. I was already done with my Bradley classes and had pre-paid most of my birth center fees. I just decided to commit to VBAC until there was a medical reason that made it unsafe.

To be clear though...a severe uterine rupture could result in a hysterectomy but those odds are very low and are not limited to VBACs. A RCS could also lead to complications that require a hysterectomy. There is no birth scenario that can exclude all of the risks. You just have to decide which ones you want to worry about and which ones you can influence. I wasn't scared of any risks with my first pregnancy but now that I'm a mom it is easier to worry as there is more on the line. I think this is normal.

Harper'smom · March 2012

My follow up ultrasound was at 31 weeks. It was scheduled for 30 weeks but had to be pushed back.

hermione76 · March 2012

Harper'smom:
My follow up ultrasound was at 31 weeks. It was scheduled for 30 weeks but had to be pushed back.

Thanks!

Aimlc1281 · March 2012

I'm so glad you asked this question. I also have an anterior placenta this time and had no idea it could affect the VBAC. I'll have to ask my dr today about it. Thanks!

hermione76 · March 2012

Aimlc1281:
I'm so glad you asked this question. I also have an anterior placenta this time and had no idea it could affect the VBAC. I'll have to ask my dr today about it. Thanks!

Hopefully you get good news!

Jessimurph · March 2012

I have one. I was very concerned about it, but I had an ultrasound at 36 weeks and it was no where near my cs scar. I have read that an anterior placenta can lead to a complicated cs in general so it made me even more motivated to have a vbac after I found out it was away from the scar.

hermione76 · March 2012

Jessimurph:
I have one. I was very concerned about it, but I had an ultrasound at 36 weeks and it was no where near my cs scar. I have read that an anterior placenta can lead to a complicated cs in general so it made me even more motivated to have a vbac after I found out it was away from the scar.

Glad to hear that you got good news. I am trying to stay calm and not think about it. I am very motivated to have a VBAC and I hope I still can.

AB&TB · March 2012

Aimlc1281:
I'm so glad you asked this question. I also have an anterior placenta this time and had no idea it could affect the VBAC. I'll have to ask my dr today about it. Thanks!

This for me too. I had no idea it was an issue. I will definitely be asking about this at future appointments.

elmnop · March 2012

I just had my 28 week ultrasound and the doctor told me that I have a low lying anterior placenta and that as of right now he is going to advise me against a VBAC. We rescheduled another ultrasound for when I am in my 34th week.

I cried

hermione76 · March 2012

elmnop:
I just had my 28 week ultrasound and the doctor told me that I have a low lying anterior placenta and that as of right now he is going to advise me against a VBAC. We rescheduled another ultrasound for when I am in my 34th week.

I cried

I am sorry. I will think good thoughts for you. You still have plenty of time for things to change.

Luvmy2sons · March 2012

AB&TB:

Aimlc1281:
I'm so glad you asked this question. I also have an anterior placenta this time and had no idea it could affect the VBAC. I'll have to ask my dr today about it. Thanks!

This for me too. I had no idea it was an issue. I will definitely be asking about this at future appointments.

Me too. I had NO idea.

Katietwin · March 2012

I have an anterior placenta as well, and my Docs have been fully supportive of my attempting a VBAC. No one has even said anything about it being an issue. I may request a late u/s just to verify the whereabouts of the placenta in relation to my scar - but I'm not overly concerned, as they're not.

K

Saltina11 · March 2012

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