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Bilobed placenta and the upcoming 28 week scan

04/05/2013

Belle

Today marks 28 weeks. On Monday at 3:30 we have our 28 week ultrasound to check on my weird placenta and do a detailed study of the umbilical chord. I have not written a lot about this because I’m trying to enjoy the time I have with Chicken. Try as I might, I am terribly worried about this complication, and have been losing a lot of sleep lately due to it. My questions for the doctor right now are:

  1. Do I have a bilobed placenta only? Are the lobes of equal or unequal (succenturiate) size? Where in the uterus are the lobes located?
  2. How is my chord inserted? Can you do a color doppler scan and/or a 3d scan to determine blood flow and if there is any velamentous insertion?
  3. Is there vasa previa velamentous insertion?
  4. What are the risks to my baby?
  5. What can be done to minimize these risks?
  6. Is there a doctor who specializes in this in the area?

From my research I think the best case scenario is that I have a bilobed placenta with lobes of equal size. I know the chord is attached between the lobes but as long as it is not velamentous insertion, then it should be safe to deliver vaginally at full term. My biggest risk in this case is postpartum hemorrhage due to a retained lobe, which can be managed as I’ll be in the hospital, not in my bathtub!

Worst case scenario is that the lobes are unequal in size and there is velamentous insertion either with or without vasa previa. If there is vasa previa I will have a c-section around 35 weeks. If there is only velamentous insertion we will have to discuss my options. As desperately as I want to experience natural childbirth, I will not fight intervention if there is a chord insertion issue.  Twelve weeks ago I might have argued differently, but now at 28 weeks I find myself so in love and bonded with little creature who kicks and rolls daily that I can’t stand the thought of losing him/her due to my insistence on a natural birth. Time will tell.

This weekend is my Alabama baby shower. I’m super excited to see friends and family, and celebrate this little life. I am also super hesitant – the baby is not safe yet. But I realize there is nothing I can do in this situation other than embrace today and have faith that in a few more weeks I’ll bring home a healthy baby. I’ll update you all Monday evening after the scan. Until then, if anyone has had a similar placenta issue and can recommend additional questions I might want to ask please share!

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10 Comments

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  1. April 5, 2013

    I have an extra lobe too – how weird! Our elective scan found it, but the OB has not mentioned it at all. The gal who did our elective scan said that everything is just fine, just to make sure they get the whole thing out after delivery (which won’t be an issue since we’re having a c-section).

    I am wishing you good luck! I’m sure it’s frightening since they wanted to follow up on it. I hope you get nothing but good news!

    • April 5, 2013

      Really? Crazy! My new doc says that placenta deformities like these are more common in IVF pregnancies. Perhaps that is why. I’m glad yours checks out ok, though! This gives me hope. 🙂

  2. April 5, 2013

    Wow, you’ve done your research as I have no idea what any of that means! I’m sure your dr will be impressed/annoyed :). I’m glad you are falling in love with your little chicken. And I know the feeling, at some point you just want your baby safe and sound.

    • April 5, 2013

      Lol! Girl, I annoy so many doctors with my research. BUT if you don’t prepare you often don’t get the entire story 🙂 And yes, I am so in love with the Chicken. I should write about this soon. My worry about not bonding was over nothing. While I still don’t converse with the baby, I do feel intense connections and am certain he/she feels the same.

  3. April 5, 2013

    Very glad you’re going into this appointment prepared and educated. I think it only helps to know ahead of time what to be looking for and the types of questions to ask. Hoping for an uneventful 28 week scan and that you have a wonderful time at your baby shower!

  4. April 5, 2013

    Interesting, I’ve never heard of such a thing but it sounds like what I had and what caused my hemorrhage! When everything was settled and I was recovering my midwife spread out the pieces (that she dug out of me, fun!) that were left in my uterus after I delivered the placenta. It was like a web that had grown on the lining of the womb. I have a picture, it’s fascinating!!

  5. April 5, 2013

    Holy Moly!! I actually goggled the terms you mentioned on your blog. And I thought, infertility and assisted reproduction technologies gets us close to most fancy and long acronyms, but this takes the cherry and the cake.
    I hope none of your worst fears happen, and you get your natural childbirth as you desire. 28 weeks is pretty safe, no? You have crossed viability and all worst case situations lead to baby back home. Anyway, hoping the baby keeps cooking for the whole 40 weeks and comes out bang on the due date. Enjoy your baby shower.

  6. jak #
    April 5, 2013

    we havent had a detailed look at the placenta AT ALL. so i’m guessing that mostly this does not become a problem or else docs would be checking for it all of the time.

    my guess is that with frequent monitoring of where chicken is, where placenta-book is and where the cord is, that you and chicken will be fine. considering how much chicken will move and flip between now and when he/she turns head-down to get ready for birth, your doc will prolly just keep an eye on it and then make sure things are in the right place before birth (so long as chicken is on target for size). as long as everything stays in a reasonable place, you can very likely have the natural birth you want, but key will be not letting the doctor freak you out, bringing your doula, maybe a midwife, and trying your best to refuse continuous monitoring.

    have an AWESOME shower. enjoy it all. keep in mind that even if you needed to deliver tomorrow, chicken will be fine. you are doing great. enjoy this time!!!!!

  7. Ginny #
    April 5, 2013

    Good luck with the appt. Monday, you sound prepared which is a good thing! Have a fabulous and joyous shower this weekend, wishing you all the best!

  8. April 6, 2013

    Good luck with your appointment, chicken will be fine no matter what you find out, though I know it will be devastating if you can’t do a vaginal birth. It would be for me. Yay baby shower, have fun, try to relax and enjoy yourself!

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