i am weeks pregnant with a low lying placenta on

Jennie,

It is probably good that you didn't have a digital exam at this point without an ultrasound, but you really need to have an ultrasound because of the low lying placenta, not to mention all of the other things you presented with. You could possibly have placental praevia, which quite often leads to preterm labor, and can be dangerous for both you and the baby. I would call the doctor's office again and tell them you need to come in for an ultrasound. The nurse can do this and you don't even have to see the doctor if everything looks okay. If you are still cramping or bleeding, especially if you're bleeding enough to soak a pad in an hour, go straight back to the ER if they can't get you into the doctor's office right away. At this point you don't want to take any chances.

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Lori

Actually, I did have an ultrasound 2 days later, that had been scheduled before. The tech told me the placenta was marginal previa- 4mm from os, but that the cervix was closed. Does this mean I didn't lose my plug? Should I just continue bed rest?

Well, then it really was a good idea that they didn't do a vaginal exam at the ER because that could have caused much more bleeding. Your placenta is approaching the opening of the cervix but not covering it. It could be just touching the cervix. You might have lost your mucous plug, or it could have been both old and new blood from your uterus. Sometimes previa will resolve on its own. The placenta doesn't actually move away from the cervix, but as everything grows, its location can change. However, about half of all women who have placental praevia deliver before full term. Bed rest is the best thing you can do right now until you can see your doctor. Your doctor must feel that it is okay to wait if he knows about the marginal previa and bleeding. If it's okay with him that you wait, then just stay off your feet as much as possible. You probably won't get any more digital vaginal exams from this point on. Sex, sneezing, coughing can all bring on bleeding as well. So even if you stop bleeding for now, be careful and take it easy. If you start bleeding heavier, like where you can soak a pad in an hour, or if your cramps become stronger or regular, call your doctor or go to the ER. Otherwise, the treatment is usually just bed rest, and the doctor will let you do that at home as long as he feels that you have the ability to comply with his orders, have transportation, and have assistance at home. The cramping could be caused by an abruption in the uterus, and he should be able to tell you that based on your ultrasound as well. This would also explain the clot you passed.

On a personal note, I had my daughter extremely premature 15 years ago due to placental praevia (complete) that led to a hemorrhage. She only weighed 1 pound 11 ounces, but she's 15 now and doing well. Bed rest was the only thing that stopped the bleeding, and as long as I was bleeding, I had to be on COMPLETE bed rest. Take care of yourself and let me know when you get to the doctor and what they say.

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Lori