# Placenta 1.9 cm from os at 34 weeks



## JavaFinch (May 26, 2002)

I'm feeling pretty bummed after my u/s today. I had hoped that my placenta would have been further away from my os by now. It's 1.9 cm. I also asked for the millionth time if she could RULE OUT vasa previa and when she turned on the color doppler, to MY untrained eyes there were colors there and she said she didn't 'think' it was anything. I have not had one person look at me (including a perinatologist) who I felt really confident that they KNEW all the ways vasa previa can present. The peri seemed to think if your cord insertion was normal, that meant you didn't have it. I feel insecure now - like what if I have it after I've been hounding my doctors literally since before 20 weeks that I want this to be ruled out - I'm at increased risk with the placenta previa and the IVF.

She also measured small - the 29th percentile, which put her measuring almost 2 weeks behind. The fluid was a little low, too. My doctor will call me tomorrow but I just feel really down in the dumps right now. I just want everything to be OK.


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## hapersmion (Jan 5, 2007)

Sorry about the stress.









Don't they say that 2cm away from the os is usually okay for placenta previa, though? I think that is the number I've usually heard around here. And 1.9 is almost 2 - especially since you still have a few weeks of stretching to go.

If I were you, I really wouldn't worry about the fluid measurements, and definitely not the size. Ultrasound is very unreliable at measuring both those things - I think they usually just end up scaring moms by telling them "your fluid is low" or "your baby is too big/too small", when there's nothing wrong in the slightest. I wonder if they ever tell anyone they're normal? I mean, if they're saying that being in the 29th percentile is too small, I guess everything above the 70th must be too big - so only one in three babies would be the "right size".







This sounds like typical scare tactics to me - I'd really completely disregard the entire issue.

Sorry they can't give you a good answer about the vasa previa, though. If you want that information, they really should be professional enough to give it to you. Maybe they could refer you to a specialist or something, someone who might know what you're talking about? Or if that isn't an option, maybe if you sit down with them and really explain your concern and tell them exactly what you want, they'll be able to be more reassuring? Random thought - do you think they aren't giving you a definite "no" just because they don't want to be blamed if they miss something - just as a CYA tactic?

Sorry, that was rambly. Good luck, I hope you get answers. Try not to worry too much though - I bet everything IS okay.


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## clutterbug (Apr 6, 2007)

Ack, so much stress! I hope you get some reassurance from your doc tomorrow.

As PP mentioned, I think 2 cm is considered "in the clear" for previa - at least, that is the number quoted to me during my pregnancy with DS (I was 1.8 cm at my 22 week ultrasound but had cleared 2 cm by 32 weeks). So assuming your doc uses the same cutoff, you only have 1 millimetre to go...a very small amount! I was really stressed about the "too-close" measurement after my 22 week scan and called up my friend who is an Ob/Gyn to ask about it. She said that when you are that close to the cutoff measurement, they (as in most docs, I guess) would be likely to be okay with a trial of labour despite being a little on the close side. So you might try asking about that.


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## NatureMama3 (Feb 25, 2004)

fwiw, here's info on vasa previa detection via ultrasound.

http://www.greenjournal.org/cgi/content/full/95/4/572

At my 20 week the tech said that 2cm away from the OS was "in the clear" for not being previa.

Do you know if she's been consistent in growth? If she's just a 29 percentile baby that's ok, if she's slowing down I would want it to be checked more often.


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## JavaFinch (May 26, 2002)

Quote:


Originally Posted by *NatureMama3* 
fwiw, here's info on vasa previa detection via ultrasound.

http://www.greenjournal.org/cgi/content/full/95/4/572

At my 20 week the tech said that 2cm away from the OS was "in the clear" for not being previa.

Do you know if she's been consistent in growth? If she's just a 29 percentile baby that's ok, if she's slowing down I would want it to be checked more often.










Thanks for the link and thanks to everyone else who responded









She was in the 49th percentile at 27 weeks, so she fell by 20 points. I guess I'm worried because of the low placenta that it's not getting adequate blood flow from me or something - what should I request as far as it being checked - or what should be checked more often? My doctor is calling tomorrow so I hope to ask him these questions. Thanks!


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## NatureMama3 (Feb 25, 2004)

I would ask what the grade of the placenta is. They go 0-2, 0 being worse shape, 2 being best shape.

She could well have a growth spurt and catch right up, babies don't always grow on the same curve the docs use.


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## sadiejane08 (Jul 21, 2007)

JavaFinch. How worrying!









On the vasa previa, it may be that they just don't know what they're looking for, so they can't give you a definite answer. They may literally have no experience with it (it's pretty rare, and the fact it's rarely checked for just adds to the likelihood any given u/s tech or doctor will never have had to deal with it before).

If you just saw random splotches of color spread around the scan area, those were artifacts. With VP you'll see an unbroken line (or lines) of color. They may be thin and tiny. There should also be a setting on the machine to measure the pulsing through those thin lines, to rule out maternal blood vessels (if they're fetal, they'll pulse with the baby's heartbeat). If you do see something like that, you'll need another scan later--or need to get the baby to move during the scan--to rule out the cord just happening to pass by the area at the moment.

Here's a good article on detecting VP, with several pictures: http://www.prenatalmedicine.com/mate...sa/article.pdf

I wish you luck in getting some answers on this, and on your placenta moving up and out of the way!


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## JavaFinch (May 26, 2002)

Thanks, Sadiejane. They were more splotches, IIRC. You're not an u/s tech by chance, are you? I was just wondering how to find out the proper way of measuring fluid. Because the first time she measured, she got a really low number, and then when she measured again, she got 8.something, which she said was still on the low end but I believe it's 'normal'. Anyway, when she measured that time I paid more attention and noticed she was measuring more corner to corner in the pockets instead of just straight across - just curious if somehow she could have been being too generous and my fluid level is something to worry about - I'm going to try to drink a lot more water because I may have been a little dehydrated, so hoping that is all.


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## JavaFinch (May 26, 2002)

Well, the OB called and according to the other scale they used, she is in the 44th percentile, so I'm not concerned about growth anymore. But he told me the radiologist looked at the pictures from yesterday's ultrasound and think he actually may see vasa previa! I have to wait until MONDAY for another scan with specialists - I'll be 35 weeks by Monday. So according to the vasa previa organization, the standard of care for VP management is admission to a hospital at 28 weeks or so, c-section at 35 weeks! Because they do NOT want you going into labor.

So here I sit - at home - waiting until MONDAY wondering if I have a ticking time bomb inside me - after I asked 3 times previous to yesterday to have this checked and in fact would have been blown off again yesterday had I not been asking for them to clarify what those colors were that I was seeing over my cervix.

I just hope those were just 'artifacts', as you called them, and the radiologist is just inexperienced in diagnosing VP - which I don't think you even can with still shots (?)


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## sadiejane08 (Jul 21, 2007)

Hi JavaFinch, no, I'm not a u/s tech, just an overzealous person whose response to everything new is to research the heck out of it ;-).

To help put your mind a little at ease, there are people (including me) who don't get hospitalized for the duration with VP. In my case, I'm so close to the hopsital (9 minutes door to ER door) that it wouldn't buy me anything to be IN the hospital--they can't get the OR ready before I get there. To stay on top of things I'm having cervical length checks and CTGs twice a week. I've also been at the hopsital twice because I felt "different"--contractions that weren't just my regular BH, backache that didn't go away all day, that kind of thing. Our plan with our doctors is that I'll call for ANYTHING however minor.

Also, most of the papers I've read suggest 36 weeks as a good compromise between prematurity and vp risk, and that's when I'm having my c/s.

I know all too well how panicky the first days after hearing "vasa previa" are. There's a lot of good information out there on the 'net. I also joined both the US and the Dutch vasa previa groups at Yahoo. I left the US one pretty quickly (still read from time to time) because they are rigid and alarmist about the hopsitalization thing, even when it doesn't make sense (I actually had someone say "I was in the hospital when I ruptured and even then they didn't have time to save the baby, so you've GOT to be in the hospital!"














. Of course everyone's different, but I'd go insane for weeks on end in the hospital (not to mention that it isn't the healthiest place to be). The clincher for me is that, in the unlikely worst-case event of total rupture before 36 weeks, the baby can bleed out in 3 minutes or so, so even in a perfect scenario he couldn't be saved.

Take comfort in the thought that the chance of rupture before 36 weeks is very, very small, especially if your cervix is long and closed (I'd definitely ask for frequent monitoring of this). And even if you do rupture before then, there's a significant likelihood that the blood vessels won't rip immediately, so you'll have warning. Nearly all the tragic stories are from people who were unaware they had VP, and by far most of these (I counted all the stories on the VP site!) went to term or even over. Many were well into labor before there was any bleeding. Since you and I will end up with c/s at the slightest hint of labor-approaching change, the odds are actually really favorable, whether you're in the hospital or at home until 36 weeks.

If you PM me your e-mail address, I can send you some links and articles that might be helpful, especially if you need to educate your doctors.






















!


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