C-sections
bknight2018
member
Complete Placenta Previa- Scheduled C-Section
bknight2018
member
in C-sections
Was told at 22 weeks that I had a low lying placenta after I was spotting for a few days. I was put on pelvic rest and the bleeding subsided. Doc took me off pelvic rest and told me to go about my merry way as usual but that we would follow up in a few weeks with an ultrasound to see if it had progressed.
Last week, during my 27 week ultrasound, we saw that the placenta was now completely covering the cervix. Doc told me more than likely we would have a scheduled 37 week c-section, at which point they'd give me a few steroid shots and such. I haven't had any bleeding whatsoever, and wasn't put on bed rest (but no sex)... Doc told me just to take it easy. I've been reading a bunch and seeing that most doctors restrict activity with CPP, so my hubby and I decided I'd go to work and do the absolute minimum in terms of physically walking around, and as soon as I get home it's feet up and rest. So far, no bleeding and I am feeling pretty good with the exception of just general achy/pressure in my pelvic region. I am scared about the c-section, as I've read there are a lot more risks involved. I know the recovery will be rough, but I am more concerned with my baby boy's health. I am also anemic, so the blood loss associated with CPP during c-section worries me. Doc says it's a "bloodier than normal c-section" whatever that means!
I'm just looking for some reassurance...anyone have a similar circumstance? or have had one in the past???
Last week, during my 27 week ultrasound, we saw that the placenta was now completely covering the cervix. Doc told me more than likely we would have a scheduled 37 week c-section, at which point they'd give me a few steroid shots and such. I haven't had any bleeding whatsoever, and wasn't put on bed rest (but no sex)... Doc told me just to take it easy. I've been reading a bunch and seeing that most doctors restrict activity with CPP, so my hubby and I decided I'd go to work and do the absolute minimum in terms of physically walking around, and as soon as I get home it's feet up and rest. So far, no bleeding and I am feeling pretty good with the exception of just general achy/pressure in my pelvic region. I am scared about the c-section, as I've read there are a lot more risks involved. I know the recovery will be rough, but I am more concerned with my baby boy's health. I am also anemic, so the blood loss associated with CPP during c-section worries me. Doc says it's a "bloodier than normal c-section" whatever that means!
I'm just looking for some reassurance...anyone have a similar circumstance? or have had one in the past???
Re: Complete Placenta Previa- Scheduled C-Section
Hello! This is a slightly older thread but I recently had a c section for a partial posterior placenta previa and reading some of the posts on the site was helpful for me so I thought I can share my experiences here.
I was diagnosed with a partial posterior previa at 19 weeks due to an episode of painless bright red bleeding early morning. I did not need hospital admission since my bleed had resolved by the time I was seen, but I had recurrent bleeding at weeks 20, two at week 21, and one more at week 22. I was on pelvic rest but continued to work during this time. I also work in a hospital where I do a fair amount of walking every day. After the bleed at 22 weeks I took 2 weeks off from work and rested which I think helped. For some reason my bleeds were period like and often happened at night when I am sleeping.
At 30 weeks I started bleeding again and stopped working. I had one more bleed at 31 weeks and 2 more at 32. At this time I went on modified bed rest but often stayed in bed so long my back and shoulders hurt. I was really worried that the baby would be born preterm and have health issues but I think the bedrest really helped me even though there is no clear evidence that bedrest helps with previas.
I had several repeat ultrasounds during the pregnancy but I guess I was one of those lucky people who never outgrew their previas. I had my final ultrasound sound at 34 weeks (posterior partial previa had not budged) and the high risk maternal fetal specialist said he was going to recommend that I receive antenatal steroids to facilitate fetal lung development and have my c section at 35 weeks.
I personally thought 35 was a little early since fetal lung maturation happens late and there is also a lot of brain development during that last few weeks of pregnancy. There is a surfactant surge that happens at 34 weeks for the lungs and at 35 weeks, the fetal brain weighs only approx 65% that of a full term baby and also has fewer surface sulci. After discussion with my obgyn she agreed to let me go until 37 weeks which is considered early term as long as I had no further bleeding. As we know, 37-38 is early term whereas 39-40 is full term.
I eventually had my c section at 37 weeks and 1 day. As to the anemia, the risks of c section will depend on how anemic you are prior to the surgery. The placenta is very vascular and blood flows through the placenta at a rate on nearly 500mL per min near term. Considering that the average female has 65mL/kg of blood volume (pregnancy leads to an increase in both hemoglobin and volume, but since we gain more volume than hemoglobin we are actually hemidiluted compared to our prepregnancy selves) the average female probably has 4-5 liters. Average blood loss for a vaginal delivery is approx 500mL, 1000mL for a c section.
Personally, I had an estimated blood loss of approx 800mL during the surgery. My hemoglobin was 12.1 before the surgery, 10.1 immediately afterwards, and 8.5 the following morning. I am on the low side for weight at 56 kgs so I probably did not have that much blood volume in the first place. I had transient low blood pressure in the middle 80s postop but it responded to 3 liters of fluids.
Keep in mind that blood loss takes time to equalize so any blood count immediately postop would not reflect your true blood count. A CBC done several hours to a day later would be more accurate. If your blood count is low, you will likely be treated with oral iron, iv iron/epogen, or even asked to have blood transfused before the surgery. It all depends on the etiology of your low blood count and how much time you have prior to the surgery.
Anyways, medical advances have progressed significantly over the last few decades so the surgery should go fine. While c sections are considered a major abdominal surgery, physicians and hospital staff do these procedures on a routine basis and are well versed in caring for patients who need c sections. Hope everything goes well!