How to handle premature rupture of membranes?

[Rocketgal]

I'm 38 weeks and 4 days, it's my first baby. I had a small leak last night. Was wearing my flannel pajamas and had a wet spot about 9 inches around, I'm as certain as one can be that it wasn't urine. :-) I know my grandmother had a small leak with one of her pregnancies in her fifth month and she carried the baby for three more months that way with no problems, but times (and doctors) were different then, you know? I'm afraid my midwife will want me to be induced. I have an appointment with her this morning. :-( I am having mild contractions, but I've been having mild contractions for a few weeks now so I'm not getting my hopes up. Lost my mucous plug starting Friday, most of it went on Saturday and still a bit more went just this morning (Monday).

Wish me luck, I'd like to hear what you think. It's been about ten hours since my leak and no labor.

Oops, I'm not sure it's called premature rupture since the baby's not premature but anyway I just mean when your water leaks before labor starts up.

Thanks ladies, my midwife is great about not doing vaginal exams, she doesn't even do them during labor lol.

The smell was odorless, and I had my nose right in there! *bashful*

[Lizbiz]

Hi Rocketgal, I don't have a lot to tell you - but when we took our birthing class - the teacher (an experienced doula) told us that one client went two days with her water broken - she was just super careful about hygiene. She didn't want to be induced either, and delivered just fine. Sounds like you might be real close to going into labor.

If you are really opposed to being induced and otherwise things seem fine, then I'd try to work with your midwife to wait and see what happens. For now, my best advice is to trust your instincts and try to relax as much as you can.

[logcabinmomma]

Nothing in the vagina, pat to wipe after peeing, take your temperature every 4 hours to make sure it's not going up and you can use a breast pump for nipple stimulations to start bigger contractions. Use it for about 45 minutes and then rest for 15 and see if the contrax pick up and keep going.

If it was a small amount and you're not still leaking fluid, it could have been only one layer of the amniotic sac, or up high where it could reseal. If you're still leaking fluid with change of position (after sitting/laying, when standing, etc), I would start trying to stimulate contractions.

You sound like you're actually in early labor and this is the beginning of a steady progression toward a baby.

-Kristi

[flapjack]

The NICE guidelines in the UK suggest that it's safe to wait 96 hours as long as you keep everything out of the vagina, but I'd monitor your temperature as well. Do you know your GBS status?
I have to say, are you absolutely SURE that your waters went? Are you still leaking now? What did your pyjamas smell like?
It doesn't sound like you're going to make it to 40 weeks, it sounds like baby is on its way and your labour is just unfolding gently.

[laohaire]

Ditto - nothing in vagina at all, even being careful wiping after pee.

THAT MEANS NO VAGINAL EXAM! Depending on the kind of philosophy your midwife has, she may push you for a VE. Decline, and stand your ground if necessary. There is no reason for a VE, just to see the state of your cervix which means almost nothing since the state of your cervix can change very suddenly.

Also, drink lots of water to replace any fluid that is lost. And yeah, monitor your temp from time to time. Your MW will probably want to listen to the baby's heart.

Amniotic fluid tends to smell a bit like semen.

ETA: On VE's - depending on your philosophy, a VE may be fine and even welcome if you're actually in progressive labor. I just meant that having a VE before you're in labor puts you "on the clock" so to speak and introduces bacteria into the birthing canal.

[jrabbit]

this happened to me with my first at 37 weeks. I went to the office, and they did a nst (I think that's what it was, some contraption that recorded heartbeat and stuff, nothing invasive), which showed that I was having contractions (very mild, I didn't know). I was told to rest and go to the hospital at 9:00 that night (planned, with mw). In case anything happened during the night, they'd rather I was in the hospital already. They did another nst, all was fine, no change, gave me a sleeping pill, and sent me to a room ... at about midnight, labor started! I never got any sleep

what I'm trying to say is no big deal. I wore a pad all day long, it was definitely not urine, and it was a constant leak. It was wait-and-see as far as they were concerned. I was allowed to labor in the bathtub, too.

2nd dd, water broke half hour before she was born 42w5d, after 3 hours back labor, she turned!!

best wishes! get some rest today!
--janis

[sarahn4639]

If you aren't still leaking I'd say it wasn't your water. It is very possible and normal that it was simply a large amount of discharge. Pregnant women are very juicy at the end (that sounds gross, sorry). Many women wear pantyliners and such because of the amount. I had a couple times with my last pregnancy where I realy questioned if my water had broken or not, well it was not. If you continue to leak then I would consider waters ruptured but if it hasn't continued I'd say it was something else. Good luck!

[MsBlack]

Yes--it could be a leak between the 2 amniotic sac layers, or a high leak--neither of which is a problem at all.

I would not say that there is any reason to try to stimulate things along, not just yet. Save that for later, if leaking becomes more pronounced. Things will happen in the right way, most likely, without interference. i'm with those who say it sounds like you're on your way, gently and slowly....enjoy!

VE--becomes safe once 'active labor' is established. No need for it now anyway (nor usually much 'need' later!) but it's definitely far less safe now than it would be once you are obviously in hard labor. At that point, the flow of energy and fluids is more distinctly 'down and out', and VE is less likely to cause any lower-tract germs to be pushed into higher regions where they will stay long enough to grow. that is, VE can always push lower-tract organisms up into higher vag tract--but in well-established labor, that downward and outward flow will tend to push things back downward. Right now, with no labor established nor even much leakage if any, germs pushed higher will tend to stay there and possibly grow into an infection.

And yes, if your mw mentions VE I would be very firm about not allowing that....you don't know how long it will take for labor to become active and so it's best to be on the safe side when it comes to the small chances of infection.

Yes--it is called 'premature rupture of membranes'--PROM. In this case, 'premature' only means that it happened prior to active labor, which I guess docs consider 'too early' tho it is just a variation of normal. P-PROM is 'PRETERM, premature rupture of membranes'--this is when rupture occurs prior to term and also before contractions start. I hate the term PROM--it's really not accurate at all. Maybe we could think of it as "PRE-CONTRACTIONS rupture' instead of 'premature rupture'....which at least is a more neutral description instead of the judgement/negativity attached to 'premature'.

[Kim919]

Agree with all of the other ladies about hygine, but also wanted to add that you can purchase litmus paper at a good pharmacy. Amniotic fluid has a different reaction with litmus paper then urine and vaginal discharge. That way you would know exactly what you were dealing with, and possibly be able to lay your worries to rest if it turns out it wasnt a PROM after all.

[logcabinmomma]

Originally Posted by MsBlack

I hate the term PROM--it's really not accurate at all. Maybe we could think of it as "PRE-CONTRACTIONS rupture' instead of 'premature rupture'....which at least is a more neutral description instead of the judgement/negativity attached to 'premature'.

I also hate this term. I had PROM beginning my labor for 3 of my 6 deliveries so far. Usually occurring 8 hours or so before active labor. I try to stay upright somewhat (keeping baby's head on cervix) and somewhat active. Depends type underwear are AWESOME for this. You can still move around and not gush. Otherwise you're chained to the bathroom changing pads all day long. I use them for when my water breaks until 24 hours pp.

-Kristi

[Belleweather]

Originally Posted by sarahn4639

If you aren't still leaking I'd say it wasn't your water. It is very possible and normal that it was simply a large amount of discharge. Pregnant women are very juicy at the end (that sounds gross, sorry). Many women wear pantyliners and such because of the amount. I had a couple times with my last pregnancy where I realy questioned if my water had broken or not, well it was not. If you continue to leak then I would consider waters ruptured but if it hasn't continued I'd say it was something else. Good luck!

I agree with this!

When your water really starts ongoing leaking, you'll know. It's a sensation that is oddly like peeing yourself, except that it doesn't stop. Strangely, actually peeing yourself, or big wet discharges can often feel like your water is breaking. I'd mention it to your midwife, but not get too excited or worried about it unless you have a continuing leak.

[AutumnAir]

I had PROM at 42 weeks + 3 days. I leaked quite a bit over the space of an hour - coming out with extremely mild contractions. It was definitely amniotic fluid but the contractions petered out, despite all I could do to keep them going. Midwife thought it was probably a hindwater leak that resealed itself. I was really careful about hygiene and took my temperature every 6 hours until I finally went into labour at 43 weeks (4 days later). If you continue to leak it may be more of an issue, but I think if you leak some then it stops the leak has most likely resealed itself and there's no need to go rushing to be induced. Good luck - hope labour goes well for you.

[TzippityDoulah]

there should be no problem if you just have a leak. esp since you're 38+ weeks. you could go into labour at anytime. if it was one leak and you feel little to nothing else you will now it has resealed, or atleast is in a place it can't leak (like up high). rest a lot. lay down with your feet up. don't get up except to pee. and drink A LOT of water for a while so you'r water will refill (it really will, I promise hehe)

and everyone is right NOTHING in the vagina. NOTHING. and use a peri bottle to wash with if possible. toilet paper can have germs. use clean fresh form the dryer towels when drying your vaginal area. and RESIST the urge to get checked esp if you are not contracting regularly.