Pregnancy Journal: Week 23

Placental Previa

I recently had two ultrasounds, and it was noted that my placental was very low and partially obstructing my cervix. This week (23 weeks pregnant), I was able to meet with my consultant (the obstetric specialist at the hospital) and he discussed what was found with me.

I have been diagnosed as having placental previa. Although this sounds complicated, in fact it is simple to explain. It means that my placenta has positioned itself abnormally low, and is at least partially blocking the cervix. This condition affects about 0.5 % of all pregnancies, and although it can affect anyone, it is more likely if you have previously had a caesarean section (I have) or multiple pregnancies close together. It does not affect the health or development of your baby during pregnancy.

Most of the time, placental previa will correct itself and does not require any medical intervention. Depending on what research you read, and how far into the pregnancy you are diagnosed, between 60 and 90% of all cases of placental previa will disappear by full term. As the baby grows and the uterus expands, the placenta is pulled upwards and out of the way.

Placenta previa becomes important at birth. If it is still obstructing the cervix, then the baby can not be born naturally and must be delivered by c-section. In countries where c-sections and other medical supervision are not available during the birth, the baby will almost always die during the birth, and it can be very dangerous for the mother as well. If you have been properly cared for during pregnancy, and have a planned caesarean, the risks for both baby and mother are no higher than for any other birth.

As I am only 23 weeks into the pregnancy now, there is a good chance that the placenta will be pulled upwards out of the way and it will not be a problem. The consultant has scheduled another ultrasound for me about a month before the baby is born. During the scan, they will be able to check the position of the placenta. After that, we will be able to discuss whether it is still an issue and what the plan is for the birth.

Even if you have been diagnosed with placental previa, make sure to discuss your options for birth. There are four different levels of severity of placental previa, ranging from mildly in the way to completely obstructing the cervix. Although in more severe cases it is absolutely necessary to have a caesarean, it milder forms it is sometimes possible, under constant monitoring, to have a normal vaginal delivery. Make sure to discuss all of your choices and their implications with your health-care team.

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