My Pregnancy Complication: Placenta Previa

My pregnancy story is not at all riddled with groans and pains of labor in a vaginal delivery, as i imagined it would be.  I had to undergo cesarian delivery, not by choice but out of necessity. My baby had to be delivered via c-section because of a pregnancy complication known as placenta previa.

What is it?

The American Pregnancy Association defines placenta previa as a "condition where the placenta lies low in the uterus and partially or completely covers the cervix."  I understood it as the condition wherein my baby can't pass through my vagina because the placenta blocks his passage.  The placenta is the pancake-shaped sac inside uterus that holds blood, nutrients and food for my unborn baby.

[caption id="attachment_465" align="aligncenter" width="300"] Source of Photo: tbh.org[/caption]

How it was diagnosed

Four months into my pregnancy, i was rushed to the hospital because of spotting.  We got worried because it was the first time ever that i leaked some blood.  The OB in the emergency room ordered an ultrasound. I  had to be admitted for overnight observation.

At the ER i was asked several questions like:

• "Nararamdaman mo ba parang may menstruation ka before ung bleeding?"


• "Napagod ka pa recently?"


• "Kailan ang last contact nyo mag-asawa?" Translation: Kailan kayo last nagsex?

Yup. That intrusive. But ok lang, para maliwanagan ako, saka ung mga doctor kung anong nangyari.

When the ultrasound results came out, my OB confirmed it. Placenta previa nga.  Hindi lang basta previa ha. Sa ultrasound report ang nakasulat: Placenta Previa Totalis. This means, sobrang laki nung overlap ng placenta at nung opening. This means the placenta completely covers the cervix. Argghhh...

It was the first time i ever took placenta previa seriously. I read about this haphazardly in the book "What to Expect When You're Expecting" but it didn't really strike me as important. From then on i tried to know everything about this condition.

Doctor's orders

I was ordered to have a 2-week bed rest after the scare of my first spotting event. So bale, naka-emergency leave ako for 2 weeks. Complete bed rest daw talaga kailangan para ma-relax ang uterus ko. Tumatayo lang ako sa kama pag kailangan mag-weewee at mag-poopoo.  OB also prescribed duvadilan twice a day and once when i feel any contractions. In my medical certificate, i was ordered bed due to threatened abortion...yikes!

A note on bed rest, not all previa cases require bed rest. According to my OB, some get by even without bed rest.  It really depends on two factors: how far along in the pregnancy and how profuse the bleeding is.

My OB says the condition isn't really that bad. Having this condition is not life threatening. I just have to take extra care and be on guard for any spotting at any point in your pregnancy. She said i should avoid getting tired.

Complication

The worst scenario is excessive blood loss. The danger is, according to the OB, once you have severe spotting, she’ll need to deliver baby even if i'm months before due date. Ito ay kapag sobrang dami ng dugo ha.  Nung narinig ko ito talagang natakot ako. For the first time sa pagbubuntis ko, napraning ako. Posible pala ako makunan!

We asked our OB about the implications of placent previa on my pregancy.  My OB says that i'm more prone to severe blood loss, so i'm more likely to undergo a cesarian delivery.  According  to her,  I should not reach the point of active labor since placenta previa cases are prone to excessive blood loss. As soon as baby has reached his full term, he'll be delivered.

However i'd like to point out that not all previa pregnancies end with cesarian. Placenta previa may clear up in the late stages of pregnancy.  My OB said the position of the placenta can shift as the uterus muscles stretch to accommodate my growing baby. She said she had one patient whose previa cleared up in the last trimester.

Well we did pray and hoped that later in my pregnancy, it will improve. But in our last ultrasound (7th month), I still had it. So we had to accept that in deed, I had to deliver baby via C section. We were  scheduled for a C section any day from January 6  to 13, 2012, which corresponds to baby's 38^th week of gestation.

[caption id="attachment_3269" align="aligncenter" width="277"] This was baby's last prenatal ultrasound. Can visualize the placenta on the upper left portion? It lies right next to baby's forehead. At 7 months, my placenta still blocks the cervix, which is baby's natural way out![/caption]

Who's at risk?

While doing a research on my condition, I came across a list of risk factors why some women are prone to placenta previa. Here's the list as stated in the Mayoclinic article.

Women are at higher risk for placenta previa if they've 
had previous surgeries involving the uterus, such as:
• A C-section
Surgery to remove uterine fibroids
• Dilation and curettage (D&C), though this is a much lower risk
Placenta previa is also more common among women who:
• Have already delivered at least one baby
• Had placenta previa with a previous pregnancy
• If you are carrying twins, triplets or other multiples
• Are age 35 or older
• Are Asian
• Smoke

I’m really baffled because I did not  fit into these characteristics, except for being  Asian. I don’t smoke. It was my first time to pregnant. I was just 29 when I got pregnant. Hindi ko talaga matanggap noong una na considered "high risk" na agad ang pagbubuntis ko.

So I asked my OB, why and how i had this condition. What did I do that put my placenta in such problematic position? Could i have prevented this? Bakit ako pa eh wala naman akong risk factor?  She said there’s really no clear explanation why and how placenta previa develops. They're no really sure what causes this pregnancy complication.

Moms, if you're diagnosed with placenta previa, you need to take extra care.  Be on guard for any bleeding.  Avoid excessive activities as this can cause uterine contractions. After i was diagnosed, i was not allowed to climb stairs, go on long walks and even have sex. (Sadddd)

The good news is: Placenta previa has no long term effect on baby or on you. Once you pass the 7^th month, you can relax a bit because at this stage almost all of baby’s organs are formed. Past seven months, it’s a matter of waiting for (and preparing for) your baby's full development and maturity.

Also worth reading:

• Placenta previa do's and don'ts!


• Learnings from an emergency cesarean delivery

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