20 week scan
Hi ladies,
Well the 20 week scan was a bit mixed. Baby is great and doing perfectly well. 
The down side is they think my placenta is low lying (partial placenta praevia) and covering my c section scar (suspected placenta accreta).
Risks of which are:
- access via c section is difficult as the placenta is in the way; it might need a mid line incision which is harder to heal from and more prone to blood loss
- the placenta may not come away; this needs surgery to remove it to stop haemorrhage (risk of which is higher) and possibly hysterectomy if the bleeding can't be controlled quick enough. 
There is a 50:50 chance the placenta will migrate far enough away from the cervix to allow a VBAC but if its still over the c section scar (quite likely) it will have to be a c section due to the risk of placenta accreta.
Apparently at re-scan at 32 weeks if they suspect accreta they will c section at 36-37 weeks and I would be hospitalised form 34 weeks due to risk of bleeding. If it is covering my scar but the further tests (MRI and doppler scans) show it is pretty clear from invading the uterus then its a c section at 39 weeks.
They arrange for the senior consultant, senior anaesthetist, cross matched blood, blood bank and HDU bed to be available in any case because they can not rule out the accreta until they physically see the placenta in situ. I suppose it's good to be prepared but it all sounds rather frightening.
The added complication is the OC which needs delivery by 38 weeks. Due to c section we can not be induced unless the cervix is open and they can break the waters (unlikely at 38 or fewer weeks). Drip and pessary are out due to scar rupture risk.
So we are to be scanned at 32 weeks to see if it has 'moved' up and go from there. The OC will have a part to play or not depending and because it can rear at the last minute I don't think we are going to know what our birth options are until the last minute; that's if we have any.
Its going to be a final weigh up of the risks of PPH, placenta accreta, cholestasis and scar rupture.
I am in a bit of a spin at the moment. Quite unprepared and upset to feel robbed of any real choice or control. But who knows what happens at 32 weeks. Trying to get my head around it all and accept the unknown but it seems fairly likely we are going to have a caesarean. The VBAC rate is just 50-60% and of course we have such a limited chance. The placenta issue needs to have resolved, no OC and the cervix needs to be open for them to break my waters.
Plus having previously had a c section I am not allowed to labour past 40 weeks any way so it relies on baby coming early.
I have edited my post because having had further discussion bits were incorrect and I didn't want anyone in the same boat to read and get the wrong idea.
Here's hoping 32 weeks will give us a lucky break.
Replies
Hopefully the placenta will move by 32 weeks. Is there anything you can do to help that process? ie special exercises to encourage it's movement? I suppose it's just a wait and see game.
Try not to be too down and spend as much time as you can getting more info on the risks involved in each scenario.
Did they give you much information at the scan?
Hope you're okay x
Sadly there is nothing you can do. The placenta doesn't actually move it just stretches. A bit like drawing a blob on a balloon and then inflating it. It doesn't move but it expands away.
Trying to focus on the most likely which is that it will move. I did note that the worst case (which is vey very rare) is what Amanda Holden had. Bit scary. And they knew she had placenta accreta ahead of time too.
But yes baby is amazing looking. He or she looks different to ds even on the scan. They are a bit concerned about baby's growth so that will be reviewed too. Baby is a little under the mean but it's triggered by one d the screening test blood results which is a little low. She did dopplers on the umbilical cord arteries and these were normal so that's good but this low blood score is related to low birth weight so she is being cautious.
For now I need to just relax as I can and keep perspective.
We stayed team yellow although we were both so close to caving.
If it's bad news at the next one though I think we might change our minds to have something else to focus on if that makes sense. Keeping calm will ensure baby stays healthy and content as possible.
Unfortunately their video system was down. They have introduced a scheme where the scan is filmed and you pay ??15 for a copy. Would have been good for ds but never mind.
She took about 15 photos to make us feel better.
Hi hun , what a mixed bag as you say , such a lot to think about , so your attempt at vbac would be the best option , lots of raspberry leaf tea n perhaps reflexology to increase chances of early labour from 37 weeks ?? a lot can happen in a few weeks though n might have a different story by then , shame you couldn't get it recorded , wasn't an option for us , would have been ace as baba was so active n as you said the other kids would have loved to see it , could you get a private scan where they would record it on dvd ? hope you're keeping positive , will send all my positive vibes your way , thinking of you lovely x x
It turns out I got a little muddled and it could be a mid line c section is best. The placenta is quite low. Vbac they feel can be too uncontrolled and if there is retained placenta it would go to surgery anyway.
I'm just going to wait and see as obviously a mid confused. My midwife should be able to help next week. I could really use some clarity.
I think it is 32 week scan, consultant scan and possibly MRI. Then the team make a decision with the full picture. Apparently mid line section is ok and they try to avoid hysterectomy but you do bleed lots.
Oh I'm so sorry hun, but really glad your baby is doing well x
I guess pregnancy is always full of surprises. Everyone thinks it's a girl because of all the trouble we are having already.
Big hugs hunny! Xx
Good luck NewMrsM.
I have found a really good patient UK paper on my situation which has helped and I am talking to my midwife about it for a bit of a debrief etc tomorrow.
You see quite a bit about placenta praevia and blood loss in the 3rd trimester and needing to be hospitalised if you bleed so I want to be careful and avoid that. I'm wondering if it is safe for me to still do aqua natal as there is a lot of jumping around.
I am really scared to think I might need to be in hospital before the birth because my husband will be responsible for my son which is full on and I will miss them both so much. I'd rather my boy didn't have to be worried or confused and disrupted by it.
Certainly think this will be my final pregnancy.
Hiya , good luck for the scan today mrs m, look forward to your post x x
Hope you're ok tulip , must be such a worry , I would check with mw re aquanatal , should be fine as supported by the water but probably best to check , glad it doesn't sound as bleak as when you posted last week , hope you're managing to take it easy , know what you mean about not wanting to worry the lo's , Lily is getting a bit clingy again , think it's because she can see me changing n she's a bit worried , just giving lots of cuddles , n reading lots of stories etc to try n reassure her , bless them , be hard having to share the attention for a while , hope we can make the transition easy for them x x
Hi Evenmum,
We are finding the same. My son is quite clingy and keeps checking where I am. He seems to know something is changing and worried it means Mummy isn't coming back.
Things still feel horrible. I don't want the risk of haemorrhage or hysterectomy.
I don't know if I can face a long inpatient stay either. It was awful last time for just a week. It is the recovery I am most firghtened of because it impacts the bonding and ability to cope in those first weeks.
Oh it must be such a worry Hun, especially with a little one to worry about already. I really feel for you and hope things get better, as much as it possibly can do.
Our scan went well this afternoon, although we wanted to find out the sex this time-but our hospital doesn't although you to know, bloody ridiculous! Will have to consider paying to find out what gender our own baby is...! Main thing is baby is healthy.
Take care TulipRose, try not to worry too much (easier said than done i know)
xDx
We held out this time as we found out last time. We were thinking it would be good to help us get through the birth.
But after last week we decided that if 32 week scan isn't the simpler news we will find out then so it's a happy surprise and not tied up in a hug surgery and worry.
I hope you find a good private scan. I think if you find a good clinic you can google and there are often offers on.
I wonder why you're having!?
My DH is convinced he saw no bits and so he thinks it's a girl. Might get a shock. Everyone I know guesses girl but mainly because baby has caused us trouble already.