Another Previa Question, also on Lovenox

[Mommy97]

We had the fetal anatomy ultrasound on Monday at 17w6d pregnant by LMP. Upon completion of the abdominal ultrasound the ultrasound tech asked me if she could do a vaginal because "the placenta looked a little close to my cervix." After measurements I asked and she said that it was close to the cervix, but would not tell me anything else.

I called my OB on Wednesday to see if they had received the report and they had not. I told the nurse at that time the tech said the placenta was close to the cervix, she spoke with the doctor and restricted us from sex.

I called my OB again on Thursday afternoon (as they are out of the office Friday) and they still had not gotten the report from the tech so Friday morning I got a one page print out from the radiology dept so that I had something at out appointment on Monday (1/12) morning if they snail mailed copy from the hospital didn't make it before out appointment time.

The radiologist report states:

A single living intrauterine pregnancy in transverse position with a fetal heart rate of 139 beats per minute. The amniotic fluid volume appears withing normal limits. The placenta is posterior with the distal tip covering the internal os, consistent with a complete previa. Based on measurements, the ultrasound gestational age is 17.6 weeks. The visualized fetal anatomy is indicated on the accompanying worksheet. The cervix measures 3.8cm in length.

As I understand it, it states the furthest point is covering the cervix. How likely is it that the placenta will "move up" in my case?

I am currently on 60mg of Lovenox per day due to history of developing pulmonary emboli during two previous pregnancies and would like to know how being on Lovenox complicates this potential previa and if there is anything specific I should ask of my doctor (whom is not a high risk OB or perinatalolgist) in this situation. I understand that being on blood thinner increases risk of bleeding and bleeding out when you do bleed, and placenta previa usually has some sort of bleeding associated with it. Thus far I have experienced no bleeding of any kind, for any reason during this pregnancy (thankfully).

I have three children at home (11y, 6y, and 18m) all born vaginally. With my first pregnancy and my last pregnancy I started having preterm contractions that were causing change to my cervix. They were stopped by medications, and in my most recent pregnancy they started right before I hit 34 weeks and I was on medication and bed rest until 36 weeks. Our son baked until our induction at 37w6d. We were induced because the doctor and I decided it would be better to have me labor in a controlled environment.

I would very much like to have this baby born healthy and at term so any insight, advice, or things I should discuss with my OB would be greatly appreciated. I've never had P17 injections or a cerclage but I will consider anything at this point to help this pregnancy. I would also be interested to know if orgasms can be harmful in this situation, since I have had orgasms thanks to sex dreams caused by pregnancy hormones. Oh and I am currently still breastfeeding out son which the OB told me at our last appointment to stop because breastfeeding causes contractions. Do you have an opinion on that?

Thank-you.

[Bill Cusick MD]

Nothing to be done other than recheck at 30 weeks- will move in 90% of cases (usually well before 30 weeks)

good luck

wc

[Mommy97]

Thanks for your response! I realize your time is limited and taking the time to answer my question is greatly appreciated.

I saw my OB today and he stated that because it's complete previa, even though only the tip, that I will need a c-section. He also said the baby is transverse which usually calls for c-section anyway but since he will already be performing a c-section for the previa it doesn't really matter. He also restricted me from sex, heavy lifting, told me I needed to be very careful not to fall, and to make sure no one hits or pushes on my stomach even if it's just the kids playing around, or the dog jumping up on me. He said any of that can possible cause a blood vessel to rupture (or something of that nature) which can lead to bleeding. He went onto say that the first time I start bleeding I will be put on bed rest and watched either at home or at the hospital. The second time I bleed could very well mean emergency c-section. If the baby reaches term he will perform a planned c-section around 38 weeks.