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Question: The placenta is posterior. It's inferior limit extends down to the internal os but does not span across it. It has homogeneous echopattern: grade -1. There is a retroplacental separation with a collection at the edge of the placenta. It measures 12x04x06 mm across and 0.16ml in volume.
I am much worried about this and unable to understand my Dr. Suggest complete bed rest.
It's 12 weeks +-3.
Pls advise and explain this?
Thanking u in advance!
I am much worried about this and unable to understand my Dr. Suggest complete bed rest.
It's 12 weeks +-3.
Pls advise and explain this?
Thanking u in advance!
Brief Answer:
low lying placenta with retroplacental clot...explained.
Detailed Answer:
Hello,
Thanks for the query to HCM,
At 12 weeks period of gestation if the placenta is low lying just above the os then the concern is its position at present which can cause bleeding often if any jerks are experienced or any intercourse is practiced. Such conditions can cause inadvertent bleeding per vagina and may lead to threatened abortion.
If there has been a retroplacental clot of 12mmx4x6mm , this indicates that there had been bleeding at the uteroplacental junction and if it increases, may lead to separation of placenta ,if the bleeding continues and thereby foetal demise. Such bleeding can occur if sudden jerks are experienced while jumping, riding bikes/cars or even running ,and even during intercourse/orgasm which can initiate uterine contractions and hence increase in bleeding.
Hence the doctor has suggested complete bed rest and also would have given you pro gestational support to allow better placental invasion into endometrium and hence stability.
If there has been no bleeding per vaginum yet , then the pregnancy is still safe and the retroplacental clot can stabilise and resolve with growth in pregnancy.
So, please take bed rest and avoid intercourse completely till placenta is stabilised and climbs up the uterus with growing pregnancy , as normally seen by 32 weeks of gestation.
Regards
low lying placenta with retroplacental clot...explained.
Detailed Answer:
Hello,
Thanks for the query to HCM,
At 12 weeks period of gestation if the placenta is low lying just above the os then the concern is its position at present which can cause bleeding often if any jerks are experienced or any intercourse is practiced. Such conditions can cause inadvertent bleeding per vagina and may lead to threatened abortion.
If there has been a retroplacental clot of 12mmx4x6mm , this indicates that there had been bleeding at the uteroplacental junction and if it increases, may lead to separation of placenta ,if the bleeding continues and thereby foetal demise. Such bleeding can occur if sudden jerks are experienced while jumping, riding bikes/cars or even running ,and even during intercourse/orgasm which can initiate uterine contractions and hence increase in bleeding.
Hence the doctor has suggested complete bed rest and also would have given you pro gestational support to allow better placental invasion into endometrium and hence stability.
If there has been no bleeding per vaginum yet , then the pregnancy is still safe and the retroplacental clot can stabilise and resolve with growth in pregnancy.
So, please take bed rest and avoid intercourse completely till placenta is stabilised and climbs up the uterus with growing pregnancy , as normally seen by 32 weeks of gestation.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks a ton for ur reply,
Mine case is IVF case and Dr advises
Choragon 5000
Proluton depot 500 both once weekly
Cap Susten 200mg
And few more medicines
My bp is 100/70 and all other such things are normal.
Faced just before usg on 3/6/15 some bright red spotting only and later it was brown and now no spotting now except pinky/greyish can be felt on fingers.
Now today we have been also refrd to gyanae Dr who advise few more medicines along with injection and suggest it needs to take proper bed rest and not a very good condition for baby. It can be abortion also.
Then only we got much sacred about the situation. I hv uploaded usg report also which suggest also foetus is growing well along with above placental separation.
I would like to ask u in this scary situations what will be best position to sleep.
Pls advise me about the chances of worst? My IVF Dr says this situation is not to much worried only have complet bed rest alongwith medication but our new gyane says its worth worrying.
Also we are having LIT therapy.
Mine case is IVF case and Dr advises
Choragon 5000
Proluton depot 500 both once weekly
Cap Susten 200mg
And few more medicines
My bp is 100/70 and all other such things are normal.
Faced just before usg on 3/6/15 some bright red spotting only and later it was brown and now no spotting now except pinky/greyish can be felt on fingers.
Now today we have been also refrd to gyanae Dr who advise few more medicines along with injection and suggest it needs to take proper bed rest and not a very good condition for baby. It can be abortion also.
Then only we got much sacred about the situation. I hv uploaded usg report also which suggest also foetus is growing well along with above placental separation.
I would like to ask u in this scary situations what will be best position to sleep.
Pls advise me about the chances of worst? My IVF Dr says this situation is not to much worried only have complet bed rest alongwith medication but our new gyane says its worth worrying.
Also we are having LIT therapy.
Brief Answer:
answered
Detailed Answer:
Hello,
Unfortunately i haven't received your ultrasound report. please upload it again.
If you have been experiencing pinkish discharge still then it indicates that the bleeding has not stopped and you need to be on bed rest completely. progestational support in form of susten, proluton depot is adequate.
You can sleep any way you like at present at 12 weeks , no such restrictions as of now, but bed rest is important along with medications.
Further complete opinion about foetal condition can be rendered only after seeing the ultrasound report. Kindly upload it again.
regards
answered
Detailed Answer:
Hello,
Unfortunately i haven't received your ultrasound report. please upload it again.
If you have been experiencing pinkish discharge still then it indicates that the bleeding has not stopped and you need to be on bed rest completely. progestational support in form of susten, proluton depot is adequate.
You can sleep any way you like at present at 12 weeks , no such restrictions as of now, but bed rest is important along with medications.
Further complete opinion about foetal condition can be rendered only after seeing the ultrasound report. Kindly upload it again.
regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr
Thanks again for ur reply
I hv attached my usg report in my profile again and I can see its out there but has no option put it or upload elsewhere so can u find out there in my profile. Though report says everything about baby is alright except retroplacental separation with collection and above few more words about posterior.
Had not even heavy blood discharge before usg on 3/6/15 just few spot of bright red then it became dark brown spots n now hardly pinkish only wen I can put finger into to feel it. And lil pain at lowest abdomen.
I hv never ever conceived before since 8yrs of marriage and its 1st time we went for IVF and conceived with almost 13 weeks now.
Pls advise after evaluation of all above condition and pls pls let me know all the worst thing and precautions should I take on to carry this.
I hv gone thru some net search wherein I hv found retroplacental abruption happens after 20w and in my case does it in 12 weeks only???
Pls explain all this retroplacental separation with collection and posterior placenta with grade-1 as I mentioned earlier.
Thanks again for ur reply
I hv attached my usg report in my profile again and I can see its out there but has no option put it or upload elsewhere so can u find out there in my profile. Though report says everything about baby is alright except retroplacental separation with collection and above few more words about posterior.
Had not even heavy blood discharge before usg on 3/6/15 just few spot of bright red then it became dark brown spots n now hardly pinkish only wen I can put finger into to feel it. And lil pain at lowest abdomen.
I hv never ever conceived before since 8yrs of marriage and its 1st time we went for IVF and conceived with almost 13 weeks now.
Pls advise after evaluation of all above condition and pls pls let me know all the worst thing and precautions should I take on to carry this.
I hv gone thru some net search wherein I hv found retroplacental abruption happens after 20w and in my case does it in 12 weeks only???
Pls explain all this retroplacental separation with collection and posterior placenta with grade-1 as I mentioned earlier.
Brief Answer:
explained.....
Detailed Answer:
Hello,
I still don't see the report but never mind if it says that the heart beat is still present and foetus is fine, its okay to interpret further as foetus is still alive.
Retroplacental bleed can occur when the placental cells called cytotrophoblasts and synctitiotrophoblasts which invade the uterine endometrium tend to get separated and the blood vessels in that local area tend to rupture causing accumulation of blood in that small pocket , which if doesn't stop , it keeps getting collected and can cause further separation of the remaining placenta as well. Usually it stops on its own when the cells from the surrounding area grow further and the blood clotting mechanisms of mother's body take over and stop the bleed. Also the increasing hcg and progesterone levels promotes the cell growth further, hence protestation support is provided as well which you are already on.
The retroplacntal abruption is a type of abruption but not as what is seen in late second or third trimester when the placenta has grown to its complete size. The blood collection then is high and may be a large clot formation may occur. In early pregnancy bleed is small and can be controlled naturally. Though there are no interventions which can be planned at this juncture only way is bed rest and pro gestational support.
follow up scan is required after th pinkish discharge completely stops. It is suggested that you should not try to poke the cervix and insert your finger in to check as the placenta is already low lying and you may injure further causing secondary fresh bleed.
Any form of vaginal insertion and any form of undue jerks should be avoided completely till bleeding stops.
Placenta location is otherwise fine being posterior over the uterine wall and grade 1 maturity which is normal for this gestation but only concern about it is being low lying.
The bleed should ideally stop on its own in next 3 days if you follow absolute bed rest and do minimal movements. As the pregnancy and placenta grows further and foetal heart eat is maintained, this collection would get cocooned and shall resolve on its own and the lost placental function of this area shall be taken over by the surrounding growing placenta. Just be patient and follow bed rest. BE POSITIVE and try to be less stressed.
Regards
explained.....
Detailed Answer:
Hello,
I still don't see the report but never mind if it says that the heart beat is still present and foetus is fine, its okay to interpret further as foetus is still alive.
Retroplacental bleed can occur when the placental cells called cytotrophoblasts and synctitiotrophoblasts which invade the uterine endometrium tend to get separated and the blood vessels in that local area tend to rupture causing accumulation of blood in that small pocket , which if doesn't stop , it keeps getting collected and can cause further separation of the remaining placenta as well. Usually it stops on its own when the cells from the surrounding area grow further and the blood clotting mechanisms of mother's body take over and stop the bleed. Also the increasing hcg and progesterone levels promotes the cell growth further, hence protestation support is provided as well which you are already on.
The retroplacntal abruption is a type of abruption but not as what is seen in late second or third trimester when the placenta has grown to its complete size. The blood collection then is high and may be a large clot formation may occur. In early pregnancy bleed is small and can be controlled naturally. Though there are no interventions which can be planned at this juncture only way is bed rest and pro gestational support.
follow up scan is required after th pinkish discharge completely stops. It is suggested that you should not try to poke the cervix and insert your finger in to check as the placenta is already low lying and you may injure further causing secondary fresh bleed.
Any form of vaginal insertion and any form of undue jerks should be avoided completely till bleeding stops.
Placenta location is otherwise fine being posterior over the uterine wall and grade 1 maturity which is normal for this gestation but only concern about it is being low lying.
The bleed should ideally stop on its own in next 3 days if you follow absolute bed rest and do minimal movements. As the pregnancy and placenta grows further and foetal heart eat is maintained, this collection would get cocooned and shall resolve on its own and the lost placental function of this area shall be taken over by the surrounding growing placenta. Just be patient and follow bed rest. BE POSITIVE and try to be less stressed.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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