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Controlled rupture of membranes?

(10 Posts)
Mimile Wed 19-Aug-09 15:33:02

Hello,

Has a MW appointment this morning at 39+1 weeks. Bb's head still floating about, and the MW emphasized that I had to come in immediately if my water broke due to risk of cord prolapse. She also spoke about controlled membrane rupture in theater in case of an induction, and the possibility of CPD.

I originally had quite a laid back attitude re. the non-engaged head thing, but all this makes me think that I should maybe be a little more concerned...

Anyone went through anything similar?

DMonabonfireinadeepdarkwood Wed 19-Aug-09 21:36:57

Bump as I'm sure someone has relevant experience/knowledge...

thisisyesterday Wed 19-Aug-09 21:38:53

hmm i would quesrtion the MW a bit more.
some babies heads do not engage until you're actually in labour so i really wouldn't be worried about it.

Mimile Wed 19-Aug-09 22:59:59

Yes- that's what I had heard too, so wasn't utterly concerned, but over the last three weeks, at each check, the MW (actually, 2 separate MWs over 3 occasions)were fretting quite a bit about "the non-engaged head situation"...
Hopefully it is just them trying to be on the cautious side hmm

MummyDragon Thu 20-Aug-09 08:34:26

Just re. the controlled rupture of membranes - I had this with my first labour (at 41 weeks) but I had already started contracting so they did it to speed things up. I asked for an epidural before they did it; and I'm glad I did as everything kicked off spectacularly quickly after the membranes went ...

My second DC was actually born with the membrane intact - I didn't even know it was possible, and the midwife said she'd never seen it before, but her head emerged "in a balloon" according to DH, and then the membranes ruptured themselves as her body emerged ...

Is this your first baby?

liahgen Thu 20-Aug-09 08:47:16

look here

lilymolly Thu 20-Aug-09 09:00:57

strange hmm

I had 2 sweeps and went till 42 weeks and both times during the sweep I was 3 cms dilated yet baby head was not remotely near engaged, so eventually I had an induction by ARM (ds was born an hours later)

I made the mistake of googling ARM and cord prolapse and questioned the mw, and she told me that the risk was minimal, although I was monitored throughout the induction process.

I think she sounds rather over cautious tbh

reikizen Thu 20-Aug-09 09:09:56

It depends on whether it is your first baby, in which case we would expect the head to be engaged any time from 38 weeks and to stay there. If it is not your first baby, it is not uncommon for the head to only engage once labour has started.
There is a possiblity of cord prolapse, which is a serious scenario and would necessitate immediate delivery but I would also be concerned about why the head has not engaged in a primip (first time mum) and whether this indicated a malposition or malpresentation. (i.e. breech presentation, face presentation) or whether there was cephalic pelvic disproportion (the head was too big to enter into pelvis due to an unusual pelvic shape for example.)
Controlled artificial rupture of membrane would be done by a doctor but only after making every effort to ensure that the cord was not presenting. Do speak to your midwife again , but I think the advice about going into hospital as soon as your waters break is sound if the head is still 'in the gods' as we say. Good luck, and don't forget that even if you are hooked up to the fetal heart monitor you can still be mobile on the birth ball etc.

Mimile Thu 20-Aug-09 11:12:33

Thanks for all the replies
Yes, this is my first baby - got refered for a scan at 38 wks to check presentation (cephalic) and if anything was obstructing the bb's head - nothing apparent, placenta high up, bb's size apparently ok too.
I asked the MW whether they would carry out radiopelvimetry to exclude CPD but apparently not done routinely here in the UK (it is in France in that kind of situation).
I won't have another appointment until the day after I am due, so I guess that unless I notice a "drop" in the days to come, I won't know whether the head as actually engaged.
We'll see if a shiatsu session on Friday does anything for me hmm. Yoga teacher thinks so, anyway...

Reikizen, re. face presentation, would they have seen that on the scan? Is there anything I can do to help (positionwise etc)? Apparently, my gran told my mum that babies in the family are born "forehead" first - maybe could be linked? I have absolutely no idea...

reikizen Thu 20-Aug-09 12:25:47

Yes, they should have been able to see that on the scan if the head is not engaged but babies have a habit of shifting position. If and when you have an internal examination maybe ask the midwife/doctor if they feel your pelvic outlet is adequate as I can often feel if the outlet seems tight on examination.
I think you could try hands and knees and forward leaning positions, incase the baby is back to back which might be what your gran meant by forehead first. Perhaps squatting if your hips are up to it, but I would advise caution incase there is a good reason why your baby won't engage and it becomes 'wedged in' in an inappropriate position. A face or brow presentation can cause problems because the diameter coming through the pelvis is larger. Yoga and shiatsu are definately good whatever in my opinion!

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