I have a baby boy, who is 2 years 4 months old now. Below is what happened during my delivery time:
I had a water leakage 2 weeks before the due date given, admitted in the hospital, was put on trips for 2 or 3 hrs (I had been told that it has glucose and pain inducing medicine) to induce pain. But I didnt get the pain (though 1 and 1/2 bottles got over) and finally I had been operated, as the water content came down
I see the same problem (water leakage) faced by my relatives/friends, but they end up in normal delivery, as they got pain after they were put on pain inducing medicine.
I feel depressed sometimes why it was a cesarian for me, as I also did walking, taken good care of my health during pregnancy etc. I was/am working as a software engineer, will that be a reason?
I would like to get answers for following questions:
1. Why we face water leakage problem during pregnancy? Is there a way to prevent that next time?
2. Why some people end up in Cesarian and some end up in normal delivery, though they were all given pain inducing medicine after facing water leakage problem?
3. If first delivery is cesarian, is there a chance for second delivery to be normal, what measures / precautions to be taken to have a normal delivery?
Answered by Maria/MD Health Forum.com Team
The amniotic fluid membranes, or bag of water, should stay intact until the onset of labor. It may break at any stage of labor, causing the amniotic fluid to leak out of the vagina. This is referred to as the spontaneous rupture of membrane or SROM. However, in some women, the water breaks before labor begins, this is called premature rupture of membranes (PROM).
If the water breaks before the pregnancy reaches its 37th week, it is considered as preterm premature rupture of membranes (PPROM).
PROM occurs in about 12% of all pregnancies. Signs of PROM include: leakage of fluid, vaginal discharge, vaginal bleeding, and pelvic pressure, but there are no contractions.
The cause of PROM remains unclear. Rupture of the membranes near term is attributed to the natural weakening of the membranes or from the force of contractions. Before term, PPROM appears to be a caused by infection in the uterus. Some risk factors include smoking, multiple pregnancies (twins, triplets, etc.), prior pre-term delivery, and excess amniotic fluid (polyhydramnios).
Premature rupture of membranes can put the baby at risk of chorioamnionitis, or the infection of fetal membrane and amniotic fluid. This poses a significant threat to both the mother and baby. Typically, if PROM occurs at term or after 37 weeks, the treatment is to induce labor if the you do not go into labor naturally. It is possible to have a normal delivery and your baby might not have further complications.
If the the bag of water ruptures between 34 and 36 weeks, the treatment is more complicated. Your doctors will give antibiotics for group B strep bacteria and then deliver the baby. If the fetal lungs are found to be immature, corticosteroids may be given to promote lung maturity.
Certain factors are considered in making decision whether to deliver the baby vaginally or by Caesarian section (CS). Normal delivery is possible if the labor would progress, the fetal position and size would suit vaginal delivery, and if the baby has a healthy heart rate.
Caesarean section is usually done when vaginal delivery would put the baby’s or mother’s life or health at risk. In PROM, your doctor may opt for C-section if there are signs of fetal distress, you’re having prolonged labor and if you develop signs of infection. Such hindrances to normal delivery are beyond your control, hence, you should not feel bad because your baby was delivered surgically. Like what you have mentioned, your relatives responded well to the labor induction and that was one of the reasons why they had normal spontaneous delivery.
To answer your question about future pregnancies, there is a chance for normal delivery if you did not have cephalopelvic disproportion. A condition in which your baby’s head or body is too large to fit through your pelvis. If you’re planning to have a baby soon, you should discuss your concerns with your doctor.
There are no known ways to actively prevent premature rupture of membranes. However, since cigarette smoking during pregnancy has been found to at least double the risk of PROM,
mothers are advised to quit smoking as soon as possible.
This blog entry is for your general information only. I recommend that you discuss your health concerns with your own doctor.
References:
http://www.healthsystem.virginia.edu/uvahealth/peds_hrpregnant/prm.cfm
Beckmann, C., Barzansky, B., Ling, F., Laube, D. 2010. Obstetrics and Gynecology. Lippincott Williams & Wilkins.
Tags: CS, Indication for CS, premature rupture of membranes, PROM
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