PREGNANCY-BIRTH Messages for January, 1999: MORE Questions related to Anterior Placenta

MORE Questions related to Anterior Placenta

From: Carolyn

anonymous@obgyn.net

Thu, 21 Jan 1999 20:35:14 -0600 (CST)

Dr. Hill,

This is very interesting. I too was diagnosed with an anterior placenta with my last (4th) pregnancy. It didn't appear to cause me any problems...during my pregnancy. They were able to pick up fetal heartbeat with a doppler from about 10 weeks on. What REALLY interests me about this is the Placenta Increta. Now, I have NOT had a c-sections with any of my pregnancies. My first two were live births without incident. Well, almost. With my second, I suffered from a retained/deteriorated placenta. She arrived on her own, the day BEFORE a scheduled induction, and weighed in at 9 lbs 3 oz and has been VERY healthy from the get go, but the placenta had to be removed manually and was in pieces. With this labor, I had no drugs to stimulate the labor (just to deal with the pain...good thing to as I couldn't imagine the removal process would have been fun had the epidural NOT been in place...OUCH!). I did have a miscarriage with my 3rd pregnancy and chose to have a D&C. I had absolutely NO complications from the D&C.

NOW, onto my 4th pregnancy and delivery (Sept 4th, 1998). I suffered from Placenta Increta, losing 4 liters of blood after delivery. My Dr (also Mary's Dr...Hi Mary) seemed to think that it was more related to the second pregnancy...that I probably suffered from Placenta acreta then and it is manifesting itself in each successive pregnancy by growing deeper into the uterus. Since he didn't deliver my second child, he wasn't able to say for sure though. He did say that IF we chose to become pregnant again, not only would we require a sanity check (No, he didn't say that, I did ;-), especially after taking 3 kids under 5 to Sesame Street Live! ), but he would recommend a c-section and removal of the uterus at that time. He said that IF it went to Placenta Percreta, there would be no saving the uterus. And he wouldn't be able to say for sure, although it sometimes does manifest itself on an US, but that I should prepare myself for that very possible outcome. He would support me in a decision to try again for a vaginal birth, but that the outcome of a hysterectomy would be very likely. Also, given this history, IF the placenta did not implant on the anterior side, would my risk of placenta a/in/percreta still be as high or is the incidence of repetition only high if implantation occurs in the same spot? Can I get you're thoughts on this...of course, this is just for giggles, since I'm NOT seriously thinking of a 4th (well, not yet...heh, heh, heh)...

Thanks.

-- Carolyn...really not wanting to be pregnant anytime soon!

At Sat, 16 Jan 1999, D. Ashley Hill, M.D. wrote: > >At Sat, 16 Jan 1999, Noelle wrote: > >>What are any potential 'complications' that I can be aware of with an anterior placenta? > >Noelle- >

Anterior placentas are extremely common and generally do not cause complications. The exception is if you have had a prior c/section.

Then, in some cases, the anterior placenta can attach itself to the old scar in the uterine muscle, a situation called placenta accreta (or percreta or increta, depending if the placenta goes deeper into the muscle, or even through the entire uterus, respectively). This can cause hemorrhage with delivery, necessitating blood transfusion or even hysterectomy. Fortunately, if you have never had a c/section, this is quite rare. >

Anterior placentas should only rarely cause problems finding the baby's heart beat. At 16 weeks this would not be an issue, unless you are fairly overweight. (Not a little overweight, but considerably overweight). The more likely cause of not hearing the baby's heartbeat at 16 weeks is that the darn kids move all over the place at that age, and it can sometimes be hard to track the heart rate! I would be surprised if they had a hard time your next visit, which in normal circumstances would be at 20-22 weeks or so. > >So, it sounds like you are on track. Congratulations on the pregnancy! >

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