C Section at 37 weeks - Polyhydramnios

[jeaux90]

Hi, I have suspected Polyhydramnios, so the hospital does not want me going full term and risking breaking waters etc. In addition to this my baby is breech and I am in the 36th week.

The thing is they are saying that they would want to do the c section at 37 weeks, next week, and I feel like this is a little early.

By the way, I am an expat living in Qatar, C sections are very much the norm in the Cromwell style hospital I am going to have the baby in.

What is the general view on going early at 37 weeks, anyone had a similar experience?

I had exactly the same. I was admitted to the ante-natal ward at 37 weeks, but they didn't want to do the c-section til 39 weeks. I remember I hoped they would do it straight away - but no; 2 bloody weeks I was there. Then dd went head down and they sent me home! Ended up with emergency CS after induction at 41 weeks.

I would have gone ahead at 37 weeks given the choice, I think you are considered to be at full term then anyway.

I would wait until 39 weeks unless you or the baby are at risk as there is more chance of the baby having breathing difficulties before then. I had a section at 39 weeks for breech, i think they've pushed it later in the UK because of recent research on breathing difficulties.

Have they scanned you to measure the 'pools' of fluid? They should do this to produce an Amniotic Fluid Index number (AFI) - anything over 24ish is usually considered to be polyhydramnios.

I had very mild PH - AFI of 22 - and was allowed to go full term (well, two weeks over) and deliver vaginally, although had to go into hospital at the first sniff of labour starting so I could be monitored.

If yours is mild, I'd be tempted to leave it, if that's what you feel comfortable with. However, if you have full blown polyhydramnios you may find that if you go over 37 weeks you get so very uncomfortable from carrying all that extra fluid that you'd be better off with a c-section at that point in your pregnancy rather than going full term.

With a breech baby I'm assuming you're being advised to have a c-section anyway, regardless of the polyhydramnios?

How (un)comfortable are you feeling now? Do you feel it's too early because you aren't ready yet in yourself to have the baby or because you are concerned it's too early (developmentally) for your baby?

I had polyhyd. but it wasn't discovered until after my baby was born by emergency section at 38 weeks. He was going badly downhill the day before. He weighed 6lb 12.5oz so was a good weight. He needed help and an x-ray but is 8 now and okay.

Putting aside the potential causes for polyhydramnios (2/3 no cause, 1/3 related to diabetes/normal big baby/other potential congenital problems)the accepted guidance in this country is that should a CS be required for a breech presentation (which is more common with ph) that thsi should be done ideally at 39 wks as this is when the baby is least likely to develop problems with respiratory distress problems (RDS -fluid in the lungs) which can be a problem for preterm babies and occasionally those born after 37 wks.
I would suggest that unless you are starting to have strong frequent contractions your specialists should aim more towards 39 wks rather than 37 weeks. They should also try and test for gestational diabetes by a blood test (ideally by doing a "glycosylated HbA1c test" rather than the Glucose Tolerance Test (GTT) at this late stage in the pregnancy).
Hope all goes well for the new arrival !

My AFI 33.6 so I guess this is quite high, I suspect this is why they don't want to take the risk of waters breaking.

I am wondering if I promise to toally bed rest they will let me go to 39.

I do feel pretty uncomfortable and immobile as I am of very small frame and carrying alot of extra weight with the fluid but I would last it out if needs be. The C section was already on the cards as the baby is breech and hasn't moved in weeks so I had already come to terms with that, its more of a case of when.

Can they not admit you? I was told before I went into hospital that if I went into spontaneous labour I should phone an ambulance and go on all fours with my bottom in the air! That would have been quite a sight for the ambulance crew

Thats what I was told too, portoeufino!!

An AFI of 33 is very high - mine was only 26.

If I were you I would go ahead with the CS - your baby is also breech to complicate matters even further. I went 1 week over in the end and had to have my waters broken (which took along time and two midwives to do it) and then had to be continuously monitored for the whole labour which I didnt like as I couldnt move around/have an active labour as I had planned.

Good luck x

....also, 37 weeks is considered term.

I practically flooded the delivery suite when my waters were broken! And every time I had a contraction more came out. For some reason I thought this was hysterically funny at the time. Too much G&A I expect.....

...me too!!! It was like a scene from saving private ryan...all water and blood!!!

I also kept leaking water at each contraction...although I went from 4cms dilated to delivered in 3 hours, so I'm not complaining (it was a very unpleasant 3 hours though!)