spontaneous rupture of membranes at 28 weeks

[ladylush]

My waters broke at 27+5 weeks and I was kept in hospital for a few days. My observations have been fine and there is no sign of infection as yet. Baby seems to be fine. Has this happened to anyone else at this stage and if so how was your pregnancy managed? I'm a little concerned that there are no immediate plans for an ultrasound, given that loss of amniotic fluid can restrict growth.

my sister had this happen due to incompetent cervix. her waters broke at 25 weeks and she was put on bed rest in hospital then delivered at 27+3. my nephew was in NICU and SCBU for 11 weeks. ups and downs but no major lasing effects (just mildly ashmatic). in fact he is now a bruiser and staring school in septemeber and a very bright boy and the tallest in his class.

even if contractions start it doesn't mean that they cannot stop them it usually depends on infections, but there are women than go on to have waters reform and carry on with pregnancy.

did you / do you have any underlying conditions/ complications?

Do they have a plan in place for you? When are you next to see the consultant?

Thanks forever No complications as such. I have a pretty dismal obstetric history with 4 first trimester (unexplained) m/c and bleeding up to week 14 in this pregnancy. But I also have a gorgeous 5 yr old ds who was a healthy 91b 3 oz weight born at term. Baby has been well throughout this pregnancy and was on target to be another big one - going by femur length. I have also been well and once I got over the shock of the early bleeding I relaxed into the pregnancy and felt really well. I still do actually. Glad to hear your nephew is ok -do they think the asthma was a result of being born early? Did your sister have steroids before he was born?

reikizen - plan is for me to take my temp and pulse 4 times a day, check colour of fluids and monitor fetal movements. If any concerns I am to go back to hospital. Otherwise, I see the consultant next thursday.

yes she received steriods straight away, shouldn't you have those injections as a precautionary measure?

there is no real way of knowing if the asthma was related. probably, but then half of the kids in inner city london seem to have childhood asthma. my nearly full term baby had excema and asthma too but has grown out of it.

BTW the checks you are doing at home were the checks my sister had to have but whilst hospitalised. maybe it was more serious for her because of the earlier gestation.

I think i would put myslef on bed rest as much as possible until you see the consultant. i have been on bed rest for 7 weeks so sympathise.

amniotic fluid is constantly being replaced so i am sure that in no time your fluid level will be fine. i am sure i read it somewhere that the body replenishes it.

forevermore - yes the steroids are given as a precaution. I had two doses. I suppose I was hoping that the steroids would prevent any problem with the lungs, but as you say it's hard to know the exact cause of asthma.
I think the hospital were happy to let me continue the monitoring at home because my obs were so stable (and because they needed the bed). Sorry to hear you are on bed rest. Is is pg related?

bethoo - the doctor on the ward said my body cannot replace what was lost. I have been told conflicting information tbh.

i am sure that in one of the pregnancy sites it says it does! bizarre but i know what you mean about conflicting information!

Yes, your body constantly replaces amniotic fluid and they would probably perform a scan if, on palpation, it felt like there wasn't much fluid around the baby. But please, ask the consultant about this when you see them. I hope you have had the steroid injections as this is important in maturing the lungs in case of early delivery. It is a very stressful time for you I'm sure and although bed rest isn't shown by the evidence to have any effect, you may feel happier taking it easy. Really scrupulous hygeine is important, as you are probably aware and absolutely nothing in the vagina. Be aware that premature labours can be very fast too so if you feel any tightenings or backache get checked out sooner rather than later. You are the best incubator for your baby and every day they are in the womb makes a massive difference to them. Good luck.

reikizen - thanks. I am guessing I shouldn't be having baths either. Will stick to showers and just water to clean vagina. I did have the course of steroids. I will speak to the cons. next week about the fluids issue.

ladylush...
My story..
with my first I had SPROM.. at 21weeks.. I didnt know until i went for a check up at 28weeks, where they discovered my bump was 6weeks to small.. on the scan I had very little amniotic fluid the deepest patch was 1mm,. The consultant had told me that it looked like my membranes had ruptured 6weeks previous, as the baby had a condition called dolicopholus!!(sp) basically the skull bones crossing over resemblong a cone..
I was admitted straight away and given all sorts of tests, an amniosenticious, on what little fluid was there to rule out infection.. As they couldnt see any lungs on the scan at this stage which they should at 28weeks I was given and MRI scan , and they could see the lungs forming so started me on dexamethasone.
I was kept in hospital until I delivered my daughter be c-section at 36weeks (due to my placenta starting to fail) ( in total 8weeks in hospital to the day i had DD then another week after thre birth so 9 weeks in total)

I was given high vaginal swaps twice a weeek, bloods taken twice a week and mminimum of 2 scans a week, checking for growth, and doppler.

When DD was born she weighed 4lb 14oz (2.2kg)
she was whisked away and given a lumbar puncture to check for infection, andput onto antibiotics. She is now a healthy sporty 12 and a half year old..

I know I was further on than you put I hope the story helps a little.. I never had any contractions either which astounded my medical team in St Georges (Tooting) every week they kept telling me I was going to deliver.. but my dd was a fighter and held on.. Good luck hun xx
( I have gone on to have two more pregnancies with no comlications at all.. and I now on my forth pregnancy but early days)

my waters never replenished fully my deepest patch was 1-2mm..xx
I was warned that I would not be abke to deliver naturally and it would be a c-section due to the lack of fluid, the dolicopholous and the fact that DD was a footling breech.And unable to turn

Bethoo/reikizen - at this gestation the baby makes it's own amniotic fluid rather then the mother - this happens from about 16-18 weeks gestation. It's made from swallowing amniotic fluid, then urinating it through... kind of like a continuous circle, iyswim. Only if the membranes heal themselves is there a chance that more fluid can build up.

FWIW i delivered my boys at 28 weeks, and i now have a healthy happy almost five year old running round.

thanks twoplusone - I did read your post on the other thread. Glad all went well for you I am also booked at St. Georges.

deemented - glad your ds is ok. Did you deliver two at 28 weeks? Was it twins or two separate births?

I dont think the consultant I had is still there I had Profeesor Y Ville when I was there. Good luck hun.. FWIW I did still bath everyday.. but I took that choice.
Good luck and keep us informed..

ladylush It was twins - sadly my firstborn Ciaran died shortly after birth due to a condition called Posterior Uretheral Valves - basically he couldn't wee out, so therefore couldn't make his own amniotic fluid, so his lungs couldn't develop. Hence me knowing about amniotic fluid ect.

His brother Brennan is fine now though - showed no ill effects from being born so early - is the tallest by far in his nursery class and is due to start reception come september.

Deemented - so sorry to hear of your loss How devastating You must take so much comfort from your ds I am sure. Glad he is healthy and a joy

Oh and lovely Irish names too

Ladylush, am frequent lurker, not poster but thought I would share. DS1 was born at 30+6. My waters went at 28+6 (started trickling one evening and then went overnight after I went to delivery suite to get checked out...was hoping at that stage I was merely incontinenet!).

Had steroids and I did have a scan to check size, position (breech) and placenta and also fluid levels and then once I was on antibiotics (prophylatic...because I didn't go into labour and had also tested positive for GBS earlier in pg)they were happy to let me home with monitoring...lasted nearly 2 weeks with me keeping an eye on leaking waters (they just kept leaking as they were made IYSWIM) and when they turned bloody I went back in...went into labour naturally and they would have been happy for me to deliver even though he was breech (they said it was good for his lungs to actually experience labour and delivery if poss) but he was in a bit of distress and because of that and breech they did an em CS.

He was 3lb 15 oz at birth (quite big) breathing for himself but he did have to be ventilated later when he got tired. Was on lo-flow o2 for about 6 weeks and came home at 37 weeks. All fine! He has been chesty but he had bronchiolitis and just seems to attract chest infections....but he might ahve done that anyway. Fingers crossed for you. My consultants told me thay can hang in there for a good while (although many come within 2 weeks). I would have been induced at 34 weeks if he'd hung around. They were just happy with every day I got after my waters went.

Just had a scan at 28 weeks for No.3...they've no clue why my waters went last time and so just keeping an eye on size etc this time round in case no3 makes an early arrival.

Ladylush, I seen where you left a message in my profile. My membranes ruptured at 17weeks. So actually a little over a week ago. I think you will be ok since you are further along and your baby chances of survival is higher now. Its great that you are taking the steriods for baby's lungs. I wont be able to take those until im 24weeks. I had an appt earlier and my baby boy is doing fine even though my amniotic fluid level is very low. I have you and your little one in my prayers. Make sure you are resting and not stressing

I know that this happened earlier this year to WorszelMummage at about 22 weeks. She ended up delivering at 27 weeks, and her baby is fine now despite his early arrival. Crossing fingers for you.

loulou - thanks for your post Glad your baby was ok - great weight for that gestation. I'm sure that must have helped. Did they ever find out why your waters broke early? From what I've read it seems they have no idea of the cause unless it's due to an infection. Good luck with your pregnancy

landanmom - I have everything crossed for you and hope lo hangs on. Do you live near a level 1 neonatal unit? My hospital has level 1 and 2 and it is reassuring to know that although this lo would be level 2 as past 28 weeks, that the hospital is equipped to care for babies who are younger and need more specialist care.

Duchesse - thanks How is your pregnancy going?