Getting to know my placenta previa
February 25, 2014 3:58 PM   Subscribe

I'm 24 weeks pregnant with my first child. Baby is fine, but today I was diagnosed with a complete placenta previa. I have not experienced any bleeding. I'm on pelvic rest, but my CNM didn't advise any other activity restrictions. I'm finding quite a bit of conflicting information out there, and it seems like other medical practitioners recommend partial or complete bed rest. How serious is this and what should I be doing?
posted by mmmbacon to Health & Fitness (6 answers total) 1 user marked this as a favorite
I was just looking this up a few days ago for a friend. Do not be concerned that you should be on bed rest. Those who recommend bed rest for this condition are not acting in concordance with medical evidence.
posted by treehorn+bunny at 4:09 PM on February 25, 2014 [8 favorites]

Best answer: Also, in case you don't have PubMed access, the most recent review article on the subject is this one:

Abnormal placentation: evidence-based diagnosis and management of placenta previa, placenta accreta, and vasa previa. Obstet Gynecol Surv. 2012 Aug;67(8):503-19.

I'll quote the relevant piece for you:
"There is no conclusive evidence to support bed rest, reduced activity, or avoidance of intercourse to reduce the risk of antepartum hemorrhage. Cervical cerclage in cases of placenta previa was evaluated in 2 small prospective studies without clear benefit and is not recommended."
posted by treehorn+bunny at 4:15 PM on February 25, 2014 [3 favorites]

My lovely wife had placenta previa with our second child. There was some scary bleeding a time or two, but her OBGYN kept an eye on it, and as she predicted, as the pregnancy progressed and the uterus grew up into the abdomen, the placenta came with it and things got better. She was never on bed rest and we have a beautiful 12 year old now. I agree with the others; it's no reason to panic.
posted by Gelatin at 4:52 PM on February 25, 2014 [2 favorites]

I was diagnosed with placenta praevia at about 17 weeks. The only difference between that and my next pregnancy was that I had regular ultrasounds (fortnightly?) to check the placenta placement. No bed rest, no special conditions at all - I continued working and exercising and living a normal life.

At 36 weeks I haemorraghed in the checkout line at the supermarket. I thought my waters had broken, but when I got home and checked my thankfully thick underwear and winter clothing, it wasn't my waters, it was blood. I rang the hospital, they told me to come straight in, and then said that I was staying there until I had the baby, one way or another, because although they couldn't explain the bleeding, the placenta was still intact but they weren't willing to risk me having a quick labour and a ruptured placenta, and all the risks that involves.

The product of that (caesarian) birth is now a happy, healthy, hormonal teenage girl.

I would suggest you don't over-exert yourself, but live your normal life. Don't go lifting huge logs of wood and hoisting them on your shoulders, but don't treat yourself like you're made of spun glass either. You need to keep active and as fit as you are now, to get through the rigours of pregnancy and birth. Any bleeding at all should be reported ASAP to your doctor or hospital or midwife or whoever is helping to manage this pregnancy.

But do not panic. The best advice I can give is don't skip your ultrasounds, look after yourself, and in about 16 weeks hopefully a new MiniMeFite will be born safely and easily.
posted by malibustacey9999 at 6:14 PM on February 25, 2014 [2 favorites]

I was on medical bedrest for a torn amniotic sac, and it was absolutely clear that if I was vertical or moved much, more fluid leaked. That's about the only reason to go on bedrest and it's very rare. Bedrest used to be seen as the safe reflex for pregnancy issues but now doctors recognize with good studies to back this that there are big negatives to bedrest - your muscles atrophy, you're overall less healthy and more likely to get sick etc. For me, the negatives were outweighed by the immediate high risk, but bedrest was harsh physically. If you don't need it, and placenta previa doesn't usually, your doctor is keeping you and your baby much healthier with normal activity. Just don't run a marathon or lift heavy stuff.
posted by viggorlijah at 7:38 PM on February 25, 2014 [1 favorite]

Response by poster: Thank you all so much for the science and reassurance!
posted by mmmbacon at 9:02 AM on February 27, 2014

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