Really worried about 37 week ELCS

[doingitalllagain]

I'm currently 35 weeks and have been leaking waters since last week so my consultant recommended induction at 37 weeks, I previously had a ELCS due to breech and I'm hesitant to have an induction for a VBAC so expressed I was more comfortable with a caesarean at 38/39 weeks of safe to do so. They agreed to the ELCS but not at 37/39 weeks, and are saying 37 weeks is very much the recommendation due to infection risk / PPROM. I asked if this was safe and my consultant said its term and likely to be absolutely fine but did explain the risks

I googled (my mistake) and have read thread after thread on here about caesareans and how important week 37-39 is for development and the risks of doing it early and I read some articles online about the potential risks and I've got myself in a panic. I made another appointment with my consultant and saw him today and again asked about pushing a week which he has said he won't say no to but that it is against their guidelines/medical advice and would be at my own risk.

I feel really stressed! I don't want to risk worse outcomes for the baby as opposed to if I just gave him another week or so. But don't want to risk a worse outcome by trying to avoid a worse outcome!

I've had sepsis from chorioamnionitis and my child had neonatal sepsis as a result. Wouldn't recommend.
Take the 37/40 section

Child went onto develop meningitis from this, I should add

Have they discussed antenatal steroids?

I've had both doses of the steroids 6 weeks ago due to threatened premature labour, apparently these have the best effect if you deliver within 2 weeks so I'm not sure how beneficial they'll be now. They won't give a second course I did ask

So sorry to hear you went through that. Thank you for the advice, I'm sure you're right I just wish I could stop worrying!

My firstborn was an ELCS at 37+5 due to going into labour with a breech baby and he was absolutely fine, no steroids but he was a lot bigger. Over 7lbs whereas this baby is only 4lbs so I feel like he just isn't going to be ready!

My 34 week elcs (long story) baby is absolutely fine. Had reflux but other than that it was all OK.
I'd go for 37 weeks.

Thank you, I'm glad all was well with your baby. Hopefully we'll have the same experience

The baby is at much higher risk from losing the amniotic fluid then from being born at term, 37 weeks. I have friends who had to have a CS bc of GD at 37 weeks, their babies didn’t need any special treatment or extra stay in hospital.

but losing waters is very dangerous and what I know is the baby should be delivered or induction started within 24h after losing all fluid, otherwise the risk is too great.

It’s understandable you’re worried and searching for risks. No induction, VB or CS has 0 risks. You have to look at both risks. You can’t wait weeks or a week or even a few days if you lose all fluid, even reduced fluid is dangerous.

I wouldn’t go against medical advice in this case. Hope it all goes well for both of you.

Can you compromise a bit and agree 37+2 or +3?
Is there any way they can monitor for signs of infection in the meantime?

I think you need to go with what the consultant is recommending; yes there are some risks with a c section at 37 weeks but I can only assume they think it’s a bigger risk for you to be leaking water for longer

Even going for 37 weeks, that’s still 2 weeks away, are they doing weekly scans to see you haven’t lost all fluid?

I didn’t even notice losing fluid (as I have so much discharge in pregnancy anyway) so when I was induced and they wanted to break my waters, nothing came out. That was at 40+2.

But the growth scan I had at 40 weeks showed normal fluid levels, so it must have happened during the last 2 days.

second pregnancy now, 30 weeks, and I feel like I have even more discharge than the first time. But I have a growth scan this week and will see.

Once weekly scans and swabs to check fluid levels and infection markers. I did think it would be more regular but nope!

Maybe you’re not losing fluid at a high rate so they think once a week is enough.

But things could change so don’t use any pads (they will mask the amount by absorbing it) and if you see an increase of discharge or a change in the pattern of the baby movements (fewer OR weaker), call them asap.

If at all worried just call and go, they’ll listen to the heart and do the swabs and put you at ease.

What exactly have you read about in utero development during weeks 37-39? By 37 weeks the baby is considered term. Lungs are the last thing to finish cooking and they’re good to go at week 37. I’m a bit confused by your concerns as most consultants take the view that if there are any problems then there are few benefits of staying in beyond 37 weeks.

37 weeks is classed as full term isn’t it? I thought from 37-40 weeks they were pretty much just putting weight on rather than development as such.

I would definitely take the advice you’ve been given.

I can only speak from my personal experience which was a cs at 36 weeks. Ds had a little bit of jaundice but that cleared up without much help and other than that he was fine.

Are you checking the risks of early section in a pregnancy where there hadn't been any premature rupture of membranes? If it weren't for your waters going then it would ofc be safer for baby to cook a week longer.

I really wouldn't mess around with this. My cousin had to be induced at 36w due to waters going and her and baby ended up with really bad infections and baby had to have a lumbar puncture etc :( it was an awful time for them both. Baby was fine apart from infection and needed no extra care.