Sun was gradually rising from the horizon, shining the pale light. Birds started to sing songs on the trees signalling a new day. Lisa had finished five exercises of Falun Dafa, while Andrew was still on the bed.
Lisa went to the room and woke Andrew up: Please wake up, Andrew. Today we have consultation with Dr Jack. Could you go with me?
Andrew suddenly got out of the bed and said: Sure.
After having breakfast, they came to Dr Jack’s clinic as scheduled.
Lisa and Andrew: Hi Jane, how are you?
Ms Jane: Hi Lisa, Hi Andrew. I am good, thank you! How about you?
Lisa: We are fine. Today I have an appointment to do the ultrasound and blood test for screening of fetal chromosome abnormality.
Ms Jane: Wait a minute. I am checking. Ok, I got it. Follow me please, you should do the ultrasound and blood test. After having the ultrasound result, you will see Dr Jack. But it takes about 3-5 days to get the result of the chromosome screening test.
Lisa: Got it. Thank you!
After finishing the first trimester ultrasound and taking a blood test. Lisa and Andrew entered the examination room to see Dr Jack.
Dr Jack: Hello, how are you?
Lisa and Andrew: We are good. How about you?
Dr Jack: Not bad with a pile of medical records. Sit down please. Lisa, do you have any concerns like lower abdominal pain and vaginal bleeding.
Lisa: No, thank God. I do not have any.
Dr Jack: I will explain the result for you. Your fetus is now at 12 weeks 2 days. Most of the parameters of the fetus are good including: enough organ part, nuchal translucency is in normal range with 1.2 mm, normal heart beat ect. However, the placenta seems to cover the internal cervical canal end. I will show you the picture, so that it is easier for you to understand.
Lisa said with a worried voice: is it dangerous?
Dr Jack: At this moment it is not. But this condition could cause bleeding. The condition is good or bad depending on the amount of the bleeding. We call this problem “placenta previa”, however; this condition could be resolved spontaneously in many cases as the fetus grows up. By 32 weeks of gestation, if it still exists it almost cannot be resolved.
Andrew: Is there any method to cure it?
Dr Jack: I am so sorry. At the current time, we do not have any way to cure it. The only thing we can do is to monitor the vaginal bleeding and intervene on time to minimize the possible complications. Think positively, we will try our best to make her and your baby safe. Other tests I will inform you later.
Lisa: Could I still practice five exercises of Falun Gong? I feel peaceful and energetic after I practice.
Dr Jack: Yes, you could practice as much as you can. The exercises are gentle and very beneficial. I am sorry for the bad news today. But try to stay positive, I will go with you and try the best to make you and your baby safe. The next visit would be at 20 weeks of gestation. However, just come to the hospital anytime when you have vaginal bleeding. Do you have any questions?
Lisa and Andrew: no, thanks doctor.
Dr Jack: So, it is enough for today. Bye bye!
Lisa and Andrew: bye Doctor.
What is placenta previa?
Placenta previa is defined as placental implantation that overlies or next to the internal cervical os. This condition was detected in 1-4% of pregnant women at the second trimester ultrasound and dropped to 0.3 to 0.5% at term (when the fetus got mature) (1). This means that placenta previa could be resolved spontaneously as the fetus grows and the uterus enlarges. It can cause bleeding at different amounts. Mother and fetus could be in danger if there is massive bleeding. So pregnant women with placenta previa are classified as high risk pregnancy. Usually the location of the placenta will be determined in the mid-pregnancy ultrasound by vaginal route (18+6 to 21+6 weeks of gestation) (2).
Lisa has the sign of placenta implanting over the internal cervical os at a quite early stage of the pregnancy. If this condition will persist on the mid pregnancy ultrasound or not? Please refer to the next chapter.
https://www.ganjingworld.com/s/yOz4jmoQgr
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Reference:
1. Society for Maternal-Fetal Medicine (SMFM). Electronic address: [email protected]; Gyamfi-Bannerman C. Society for Maternal-Fetal Medicine (SMFM) Consult Series #44: Management of bleeding in the late preterm period. Am J Obstet Gynecol. 2018 Jan;218(1):B2-B8. doi: 10.1016/j.ajog.2017.10.019. Epub 2017 Oct 25. PMID: 29079144.
2.Jauniaux ERM, Alfirevic Z, Bhide AG, Belfort MA, Burton GJ, Collins SL, Dornan S, Jurkovic D, Kayem G, Kingdom J, Silver R, Sentilhes L on behalf of the Royal College of Obstetricians and Gynaecologists. Placenta Praevia and Placenta Accreta: Diagnosis and Management. Green-top Guideline No. 27a. BJOG 2018