Low-Lying Placenta & Breech Baby at 25 Weeks: Risks & Cesarean Concerns

Question
i had my 1st baby through cesaerean section in2004 due to NPOL.this time in
19 wek u/s the lower end of placenta 34mm from os,my doctor advised me
bed rest.now i have changed my doctor.in my 25 week u/s the placenta is
anterior with lower end of placenta 20mm from os,also the baby is breech.in
my six week u/s the choriodecidual reaction was moderate.what are the
chances of my placenta moving up and of caesarean delivery again.

Answer
The difference in measurements could be at least partially a result of different technicians doing your ultrasounds.  Ultrasound measurements can be very tricky, and it is very common for different people to get different results when looking at the same person even on the same day.  It will be easier to tell what your placenta is doing after you have a second measurement with your new office.  Studies have shown that placentas greater than 20mm from the os at 20-26 weeks are more likely to migrate far enough by term to allow for a vaginal delivery.

I wouldn't worry about your baby being breech at this point.  Baby's position is not really fixed until 34-37 weeks, and some babies will flip even later than that.  Check out www.spinningbabies.com for suggestions on encouraging your baby to turn, but mostly relax and try not to stress too much about it.

NPOL, or non-progress of labor, is a bit of a catch-all term, and is usually applied when you have gone past the doctor or hospital's protocols for "accepted" timelines.  It means your labor was not "average," but it does NOT mean your labor was not normal, nor does it mean you would not have given birth naturally last time had you been left alone.  Current labor timelines were created in a very different environment, under different labor management techniques, than most people encounter today.  In addition, natural labor varies widely from woman to woman, and "normal" can be anything from 2 hours to 2 days (or more!).  If your placenta moves up enough to allow for a vaginal delivery, remember to not get rushed or stressed, and talk with your provider about allowing your labor to continue to progress naturally as long as there is no distress.