The Challenging 41st Week – Amniotic Fluid Leak

Day: 40+1

During today’s OB visit, I mentioned that I have been having tiny leaks since Friday night, although the leaks only happened at night, when I got up and used the restroom, the size is about that  of a quarter on the sheet so I wasn’t sure if it was just leak of urine or amniotic fluid. The NST still looked great but it did turn out that the leak was positive for amniotic fluid after a check under the microscope. Neither of Dr. Grana or Dr. V were in the office today so the nurse-midwife Kim talked to us and suggested that we go to the hospital, get antibiotics and get induced right away. The reason behind it is there’s a risk of infection. Although Michael and I intuitively didn’t think that’s an emergency that requires induction right away, even though we do understand the risks of having the infection. Certain things Kim said didn’t make sense, such as induction won’t affect the timing of the milk coming in, and Pitocin doesn’t have anything to do with the use of epidural (this for a fact we know is not true, Pitocin makes labor much more painful and women who get induced usually end up using epidural because its really hard to handle the induced labor pain).

So we decided to head home and get second and third opinion before we make our decision. Dr. Gil asked about the details and made sure that since the start of leak we didn’t make love (a common way to speed up the labor by increasing prostaglanins) which could have increased the risk of infection, he’s concerned about the antibiotics and Pitocin like we do, and mentioned that sometimes the membrane will seal back up (that’s what I read about too!). Audrey was on her way back but she called back and said she had dealt with this situation and since the leak is so small and I am GBS negative, there’s no reason to be induced yet, however, we do need to closely monitor the leak and hopefully the spontaneous labor will start soon. Its also good to know that most likely I am not going to have a gush which could result in cord prolapse which is a true obstetric emergency that requires a C-section.

We called Dr. Grana and left her a message to let her know that she doesn’t need to expect us at the hospital. We were disappointed about how Kim handled the communication though, instead of explaining to us about the risks subjectively, she painted a picture of “twins fighting for their lives because of infection”, we didn’t quite like the approach of scaring the patients with possible worst outcome, even though we understand that could happen. She worked at the hospital NICU as a nurse and I finally realized the difference between CNM and a lay midwife. Instead of discussing the risks in great details, we were given an order. Also, certain things she should have talked to us about is that the infection usually occurs upward, for example: intercourse or cervix check so as long as there’s no disturbance, the risk is very small for a tiny rupture.

Since there’s a slight rupture of the membrane, Kim didn’t do a cervix check (that’s one of the top risks for infection) but she looked into the cervix and said it’s ripe and ready, the mucous plus is still in. I have been feeling tremendous pressure as well so we think the babies will be coming very soon, the fact that the leak is so tiny is probably because Baby A is fully engaged. So we ate eggplant, had dinner at S-Mart (I had spicy tofu stew which some believe the spicy food will trigger labor as well) and walked around and we prayed to the God of Pineapple (planning on eating half of it tonight), for it’s power of sour and fighting infection, lol…

This is an unexpected change of plan, however, we do expect something unexpected will take place, after weighing the risks and making our decision, we felt at ease again. I am glad Mom is supportive of our decision as well, she isn’t worried either. And virtually any action we take in life carries some risks, and only time can tell whether we’ve made the right decision for our boys we as far as this particular most challenging decision so far during the pregnancy, we are both comfortable with and responsible for it though.

So our lovely sons, it’s time to come out now! Really soon, please.

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4 Comments

Filed under Dig-In, Third Trimester

4 responses to “The Challenging 41st Week – Amniotic Fluid Leak

  1. Juan

    Mom is the GREATEST!! I couldn’t stop tears watering my eyes when I read your posts. My best for you and your boys!!

    Juan

  2. Michael

    I dislike fear mongering and this is exactly what Triangle OB/GYN is doing to us. They speak of risk of infection to the babies NOT BASED ON EVIDENCE. Please see the following article that addresses PROM (term premature rupture of membranes)
    http://www.medscape.com/viewarticle/494127

  3. Michele

    Cynthia, Ask for cranberry juice, to prevent infection, in the hospital. Sounds like it could help both before and after birth! You are doing great … this post-term wait isn’t easy. I remember having to wait five days for Maxim and when labor finally did start, it was a calm relaxing evening and I was reading a book, no signs whatsoever until I put the book down and went upstairs to go to bed.

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