Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
181 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Is caesarian section or vaginal delivery recommended?

Hi I am 32 years old, G3P0. Currently I am 37 weeks +2days pregnant, weighing 73 kgs, height of 163cm. I was diagnosed with complete placenta previa with one episode of bleeding in second trimester. Since then on bed rest. And as of today the placenta has moved 1.8cm from the internal Os. Considering my obstretic history the doctor has adviced cesarean section after 38 weeks, although trial vaginal delivery may be possible. What would be the best decision considering all the risk factors in my case? Thanks
Tue, 12 Jan 2016
Report Abuse
OBGYN 's  Response
Hello, and I hope I can help you today.

I am glad that at this point you no longer have a complete present previa as these pose the greatest risk for severe blood loss during delivery.

Your pregnancy, because the edge of the placenta is 1.8 cm from your internal office, is defined as a marginal placenta previa. Once the internal os is at least 2 cm distance from the edge of your placenta, your placenta is no longer considered a previa, but low-lying. Low-lying placenta is regarded as safe for trial of vaginal delivery, however, even marginal previas can sometimes deliver vaginally without bleeding if the head compresses the lower edge of the placenta during descent, which prevents bleeding from the edge as you dilate.

When planning a delivery of a patient with placenta previa, the doctor must weigh the risks of your going into labor (which can lead to serious, heavy rapid bleeding that can compromise both you and the baby) versus waiting for the placenta to potentially "move" further away from the cervix.

So in your case, because only 2 mm difference in distance from the os would put you outside of the definition for placenta previa, it would not be unreasonable to possibly wait one more week and reevaluate the distance of the placenta from the cervix.

However, if beforehand you experience any signs of labor, like contractions, and especially vaginal spotting, the safest thing would be to perform a cesarean section before labor.

So in summary, it is safest perform an elective cesarean section before labor. However, if you do decide to attempt a vaginal delivery, you should try to labor for the most part in the hospital rather than in homes that you may be monitored very carefully for bleeding and fetal compromise during this time.

I hope that I was able to adequately answer your question today, and that this information will be helpful to you in making the final decision about your delivery.

Best wishes for the rest of the pregnancy, and good luck with the delivery,

Dr. Brown
I find this answer helpful

2 Doctors agree with this answer

Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]
Share on
 

Related questions you may be interested in


Recent questions on Vasa praevia


Is caesarian section or vaginal delivery recommended?

Hello, and I hope I can help you today. I am glad that at this point you no longer have a complete present previa as these pose the greatest risk for severe blood loss during delivery. Your pregnancy, because the edge of the placenta is 1.8 cm from your internal office, is defined as a marginal placenta previa. Once the internal os is at least 2 cm distance from the edge of your placenta, your placenta is no longer considered a previa, but low-lying. Low-lying placenta is regarded as safe for trial of vaginal delivery, however, even marginal previas can sometimes deliver vaginally without bleeding if the head compresses the lower edge of the placenta during descent, which prevents bleeding from the edge as you dilate. When planning a delivery of a patient with placenta previa, the doctor must weigh the risks of your going into labor (which can lead to serious, heavy rapid bleeding that can compromise both you and the baby) versus waiting for the placenta to potentially move further away from the cervix. So in your case, because only 2 mm difference in distance from the os would put you outside of the definition for placenta previa, it would not be unreasonable to possibly wait one more week and reevaluate the distance of the placenta from the cervix. However, if beforehand you experience any signs of labor, like contractions, and especially vaginal spotting, the safest thing would be to perform a cesarean section before labor. So in summary, it is safest perform an elective cesarean section before labor. However, if you do decide to attempt a vaginal delivery, you should try to labor for the most part in the hospital rather than in homes that you may be monitored very carefully for bleeding and fetal compromise during this time. I hope that I was able to adequately answer your question today, and that this information will be helpful to you in making the final decision about your delivery. Best wishes for the rest of the pregnancy, and good luck with the delivery, Dr. Brown