Hello, and I hope I can help you today.
I am glad that at this point you no longer have a complete present previa as these pose the greatest risk for severe blood loss during delivery.
Your
pregnancy, because the edge of the placenta is 1.8 cm from your internal office, is defined as a marginal
placenta previa. Once the internal os is at least 2 cm distance from the edge of your placenta, your placenta is no longer considered a previa, but low-lying. Low-lying placenta is regarded as safe for trial of
vaginal delivery, however, even marginal previas can sometimes deliver vaginally without bleeding if the head compresses the lower edge of the placenta during descent, which prevents bleeding from the edge as you dilate.
When planning a delivery of a patient with placenta previa, the doctor must weigh the risks of your going into labor (which can lead to serious, heavy rapid bleeding that can compromise both you and the baby) versus waiting for the placenta to potentially "move" further away from the
cervix.
So in your case, because only 2 mm difference in distance from the os would put you outside of the definition for placenta previa, it would not be unreasonable to possibly wait one more week and reevaluate the distance of the placenta from the cervix.
However, if beforehand you experience any signs of labor, like contractions, and especially vaginal spotting, the safest thing would be to perform a cesarean section before labor.
So in summary, it is safest perform an elective cesarean section before labor. However, if you do decide to attempt a vaginal delivery, you should try to labor for the most part in the hospital rather than in homes that you may be monitored very carefully for bleeding and fetal compromise during this time.
I hope that I was able to adequately answer your question today, and that this information will be helpful to you in making the final decision about your delivery.
Best wishes for the rest of the pregnancy, and good luck with the delivery,
Dr. Brown