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What Does The Following TIFFA Scan Report Indicate?
Question: Dear Doctor,
Following observed in my (30 years old) 19 week 2 day of TIFFA scanning (Now I am on 20th week): Presentation Cephalic, Placenta-Anterior, G-0 Lower edge is totally covering the internal OS. Other observations are fine and baby growth and movement are normal as per 19 week in scan. However, I am not yet feeling the baby movement. I was told that the placenta is low lying covering the os and there will be a chance of bleeding. Further, based on above mentioned observation I have been advised by doctor to take Proluton Depot (500mg) in 15 days interval. Unfortunately, the nurse gave me 1000mg. I am totally worried about that. Will it make any complication to my baby and me. Based on that 1000mg injection doctor asked me to stop Gestin 5mg. Further, I am taking ecosprin 75, Ducofer-D3 and shelcal. Earlier I had 3 missed abortion (each happened before 6 week of pregnancy) and I am totally worry about my above mentioned situation. Kindly provide your advice on following queries.
1) What is the meaning of Cephalic, Anterior and G-0. In which category this placenta problem will come; major, moderate or minor.
2) What will be possible complication and what are things I have to take care. I am doing small activities such as cooking in my home. Is it ok?
3) Will there any chance to move Placenta to normal position?
4) If bleeding happen, will it harm the baby and mother?
5) How often I will have to monitor the position of Placenta through Scan?
6) The extra doseage of injection (Proluton Depot) has any side effect. Will it harm my baby?
7) When will I have to resume the Gestin 5 mg.
8) Yesterday blood test shows that my Hemoglobin level is 10.02? Now I am taking Ducofer-D3 twice per day. Is it sufficient?
At present I am in XXXXXXX I would like to go to my home town (kerala) as soon as possible by air (train it may take 24 hr; I do not want take that risk.) Is it safe? Would you recommend that at this stage?
Please provide your valuable suggestion.
Thanking you
With regards
Following observed in my (30 years old) 19 week 2 day of TIFFA scanning (Now I am on 20th week): Presentation Cephalic, Placenta-Anterior, G-0 Lower edge is totally covering the internal OS. Other observations are fine and baby growth and movement are normal as per 19 week in scan. However, I am not yet feeling the baby movement. I was told that the placenta is low lying covering the os and there will be a chance of bleeding. Further, based on above mentioned observation I have been advised by doctor to take Proluton Depot (500mg) in 15 days interval. Unfortunately, the nurse gave me 1000mg. I am totally worried about that. Will it make any complication to my baby and me. Based on that 1000mg injection doctor asked me to stop Gestin 5mg. Further, I am taking ecosprin 75, Ducofer-D3 and shelcal. Earlier I had 3 missed abortion (each happened before 6 week of pregnancy) and I am totally worry about my above mentioned situation. Kindly provide your advice on following queries.
1) What is the meaning of Cephalic, Anterior and G-0. In which category this placenta problem will come; major, moderate or minor.
2) What will be possible complication and what are things I have to take care. I am doing small activities such as cooking in my home. Is it ok?
3) Will there any chance to move Placenta to normal position?
4) If bleeding happen, will it harm the baby and mother?
5) How often I will have to monitor the position of Placenta through Scan?
6) The extra doseage of injection (Proluton Depot) has any side effect. Will it harm my baby?
7) When will I have to resume the Gestin 5 mg.
8) Yesterday blood test shows that my Hemoglobin level is 10.02? Now I am taking Ducofer-D3 twice per day. Is it sufficient?
At present I am in XXXXXXX I would like to go to my home town (kerala) as soon as possible by air (train it may take 24 hr; I do not want take that risk.) Is it safe? Would you recommend that at this stage?
Please provide your valuable suggestion.
Thanking you
With regards
Brief Answer:
you have complete placenta previa..high risk pregnancy..explained
Detailed Answer:
Hello,
Thanks for contacting healthcare magic.
Your TIFFA scan report at 20 weeks gestation states that foetus is healthy and growing fine but your placenta is low lying and completely covering the os which is also known as COMPLETE PLACENTA PREVIA and this puts younger high risk category.
Generally , a final diagnosis is made a 32-34 weeks by a repeat ultrasound to finally confirm the distance of placenta from the internal os to ascertain if normal delivery is possible or not. If complete placenta previous persists which it would, you will not have a vaginal delivery instead have to resort to C-SECTION ONLY. Its the indicated route.
PRECAUTIONS you have to take:-
1. there are high chances of bleeding anytime during growth pf pregnancy precipitated by jerks or preterm labour . So it is important to keep the uterus quiescent , which is why proton depot has been given to you and it has to be continued till 34-36 weeks ideally 500mg IM weekly.
2. The aim now is to avoid any form of bleeding per vaginum..as it would cause severe bleed and may cause fatal death if not attended immediately.
3. Ideally you should be hospitalised by 32 week of your gestation till delivery which is planned generally at 37 weeks of gestation when baby has matured, but the hospitalisation is to avoid any undue stress and also to cover up for any chances of mishap due to accidental antepartum haemorrhage or vaginal bleed which would require immediate c- section to save the child.
4. Complete placenta previa is Severe placenta previa and the most dangerous of all and requires outmost care in third trimester to avoid any form of bleeding.
Successful pregnancies have been continued till 38 weeks even under hospitalised supervision. Aim is to prevent bleeding.
5. Maximum bed rest after 32 weeks is advisable as walking and strenous activity can initiate uterine contractions and bleed sometimes which can be dangerous.
6.Fetal growth parameters have to be measure 3 weekly after 28 weeks and weekly after 34 weeks till 37 weeks and also to look for cervical length.
7 Under no circumstances should you get involved with intercourse or any sexual activity as it can cause onset of bleeding and can jeopardize the foetus. Neither a vaginal examination should be done in future. All ultrasounds would be abdominal.
8 Care has to taken to maintain hygiene and avoid any form of vaginal infections during pregnancy now.
9.as far as travelling is concerned, in third trimester , its just not advisable at all, as chances of bleed just doubles due to stress and strenuous activity. You may however plan your travel by air in next 2-3 weeks and go to your mom's house and rest there till delivery.
10. You may continue on iron and calcium tabs , if proton 1000mg is being taken then tab gestin is not required as both are progesterones. You haemoglobin is on the lower side , but it shall improve over next 7 weeks if you are regular on your iron tablets.
I hope i have answered your query in detail,
wishing you safe pregnancy,
regards
you have complete placenta previa..high risk pregnancy..explained
Detailed Answer:
Hello,
Thanks for contacting healthcare magic.
Your TIFFA scan report at 20 weeks gestation states that foetus is healthy and growing fine but your placenta is low lying and completely covering the os which is also known as COMPLETE PLACENTA PREVIA and this puts younger high risk category.
Generally , a final diagnosis is made a 32-34 weeks by a repeat ultrasound to finally confirm the distance of placenta from the internal os to ascertain if normal delivery is possible or not. If complete placenta previous persists which it would, you will not have a vaginal delivery instead have to resort to C-SECTION ONLY. Its the indicated route.
PRECAUTIONS you have to take:-
1. there are high chances of bleeding anytime during growth pf pregnancy precipitated by jerks or preterm labour . So it is important to keep the uterus quiescent , which is why proton depot has been given to you and it has to be continued till 34-36 weeks ideally 500mg IM weekly.
2. The aim now is to avoid any form of bleeding per vaginum..as it would cause severe bleed and may cause fatal death if not attended immediately.
3. Ideally you should be hospitalised by 32 week of your gestation till delivery which is planned generally at 37 weeks of gestation when baby has matured, but the hospitalisation is to avoid any undue stress and also to cover up for any chances of mishap due to accidental antepartum haemorrhage or vaginal bleed which would require immediate c- section to save the child.
4. Complete placenta previa is Severe placenta previa and the most dangerous of all and requires outmost care in third trimester to avoid any form of bleeding.
Successful pregnancies have been continued till 38 weeks even under hospitalised supervision. Aim is to prevent bleeding.
5. Maximum bed rest after 32 weeks is advisable as walking and strenous activity can initiate uterine contractions and bleed sometimes which can be dangerous.
6.Fetal growth parameters have to be measure 3 weekly after 28 weeks and weekly after 34 weeks till 37 weeks and also to look for cervical length.
7 Under no circumstances should you get involved with intercourse or any sexual activity as it can cause onset of bleeding and can jeopardize the foetus. Neither a vaginal examination should be done in future. All ultrasounds would be abdominal.
8 Care has to taken to maintain hygiene and avoid any form of vaginal infections during pregnancy now.
9.as far as travelling is concerned, in third trimester , its just not advisable at all, as chances of bleed just doubles due to stress and strenuous activity. You may however plan your travel by air in next 2-3 weeks and go to your mom's house and rest there till delivery.
10. You may continue on iron and calcium tabs , if proton 1000mg is being taken then tab gestin is not required as both are progesterones. You haemoglobin is on the lower side , but it shall improve over next 7 weeks if you are regular on your iron tablets.
I hope i have answered your query in detail,
wishing you safe pregnancy,
regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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