Has anyone had polyhydramnios and VBAC'd? - Mothering Forums

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#1 of 9 Old 10-02-2009, 01:25 AM - Thread Starter
 
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I'm at 38 weeks and was just diagnosed with polyhydramnios. I'm under midwife care in an OB practice, and was planning a VBAC in the hospital. I've had a NST now and a bio-physical u/s and the baby seems fine. My AFI is about 28.
Does anyone have any experience with this? I'm "required" to meet with an OB on Monday and I think it will be suggested that I schedule a RCS.
Am I being irresponsible to even consider a VBAC at this point? We live about a half hour from the hospital and I've been told to get there immediately if my water breaks. BTW, I'm about 1 cm, 50% effaced and the baby is -3.
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#2 of 9 Old 10-02-2009, 02:14 AM
 
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I don't have any personal experience with this situation, but I don't think it's irresponsible to consider a VBAC. They checked out the babe too during your US to verify that everything looked good and that it just appears that you have too much fluid, yes?

So the big risks are cord prolapse, especially when your babe is so high, placenta abruption, and postpartum hemorrhage.

I haven't read anything that suggests that polyhydramnios is linked in any way to uterine rupture. Maybe the ICAN site would be helpful?

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#3 of 9 Old 10-02-2009, 11:55 PM - Thread Starter
 
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As far as they can tell the baby is ok. Of course I'm freaking about that anyway. I have posted on ICAN too, with not much response. I guess any of the "risks" could happen to anyone...
I'm a little nervous that DH thinks that I so "need" to VBAC that I'm willing to put the baby at risk. Not true, but I'm find it difficult to trust the doctors and I haven't been satisfied with the info I'm finding on my own.
Thanks for your response!
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#4 of 9 Old 10-03-2009, 12:26 AM
 
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Since your ultrasound was fine, you probably don't have any extra concern. If you have severe polyhydramnios, I think there is an increase risk of uterine rupture, though I'm not sure how much. Maybe someone else knows.

I had it with one of my daughters, but it was because she had a fatal neural tube defect. I totally don't want that to scare you, because trust me, it is really obvious on any ultrasound. But, regarding the extra fluid, I have to say I had a LOT, and it took about 10 minutes for it to all come out when I was giving birth, but we decided to break the bag in my situation as I'd been laboring (hard, transition labor) for 5 days and was still only 2 cm. She was born 15 minutes after we broke the bag. Of course, we weren't worried about cord prolapse, since we knew she would die shortly after birth no matter what. Anyway, my midwife broke the bag by making a very small opening at first to allow the fluid to exit slowly rather than quickly, while I laid down.

My experience was really different than yours, but at this point I wouldn't worry about it if I were you. Have they told you why they want you to come in right away when your water breaks? Why not wait until labor is well under way? That would concern me more, since it's possible your water could break well before you have active labor, which would jeopardize your VBAC to be in the hospital.

And, I doubt your water would break with your baby still so high. More likely to happen with a lot of pressure on the cervix from baby's head.
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#5 of 9 Old 10-03-2009, 12:33 AM
 
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hi, Just my opinion, but I would have to sat that a VBAc should still be an option. I'm not entirely sure but did you see a perinatologist...can't remember what you said. I'm sure that an OB will have to go along with the "decision" of the specialist.... with my 5th baby (born in Feb.of 07) I developed polyhydramnios. At 38 weeks I had a c-section (my first cs after 4 vag. births). At 33 weeks, during an ultra sound to check baby's postion, my doc. discovered a 10cm abdominal mass in the baby. We didn't know the sex of the baby but my doctor said most likely we have a baby girl who has an ovarian cyst due to circulating maternal hormones. We went to a perinatologist who confirmed that the baby was a girl with an ovarian cyst. The polyhydramnios developed over the remaining weeks, after the cyst was discovered. My doc did not immediately insist on a c-section. She was willing to wait and see if a vag. birth would happen. Thing is, I had always been induced. And in this case, with the baby so high, there was no way I could be induced. But I have to admit that I was very concerned about pushing out a baby with a 10 cm fluid filled cyst. None of my babies had ever dropped before birth, I never went into labor on my own, even after waiting 14 days passed my EDD. And this baby was no exception. She kept floating, turning from head down to head up in minutes. So, I consented to the c.s. The hospital is 40 minutes from our home. My doc. said she was concerned that the cord would drop, or the baby's arm or leg. And I just wanted the baby to be born, so we could "deal with" the cyst. I'm sorry if I haven't helped you at all. I just wanted to share my experience with polyhydramnios. By the way, the cyst in my little girl disappeared on it's own within 1.5 years. If the cyst hadn't been seen on US, we would never have known it was there. She was completely unphased by it. I give God all the glory for that one. That's a huge cyst, esp. on a tiny baby. 10 weeks ago I had our 6th baby, a 10.2 lb baby boy. Blessings to you, mama. Please continue to post about your delivery & baby.

Dana, Wife to DH, SAHM to Mac, 14, Mikael, 10, Holland Eve, 8, Danica Lyn, 5, Noah Rebekah, 3, & baby brother Elisha Isaac, born 7/21/09
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#6 of 9 Old 10-06-2009, 06:07 PM
 
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I believe I have had two pregnancies with this issue, and it has never been suggested that because of this I needed a c/s.

I will say with my daughter it was discovered at around 40 weeks. The main concern my OB had with her, like yours, being so high up was of cord prolapse, which is probably why they want you at the hospital after your water breaks to ensure there is no prolapse.

I will say that my BOW is what dilated my cervix and was coming out (like it was a +2 and she was a -3 or greater). My water eventually broke, no prolapse, and boy was there lots and lots and lots of water...
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#7 of 9 Old 10-07-2009, 05:31 PM
 
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Quote:
Originally Posted by moonglowmama View Post
Have they told you why they want you to come in right away when your water breaks? Why not wait until labor is well under way? That would concern me more, since it's possible your water could break well before you have active labor, which would jeopardize your VBAC to be in the hospital.
I'm obviously not the OP, but I have a guess at the answer to this. My OB has said I need to come in during early labor, too, simply because I'm a VBAC patient. I just nod and smile. My plan is to labor at home with my doula for as long as possible. There's no way in hell I'm going in early and then having them say I need a C-section because of "failure to progress."

So I'm guessing the doctor's orders don't necessarily have much to do with the fluid levels, but more to do with the fact that she's a VBAC patient in the first place.

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#8 of 9 Old 10-07-2009, 07:49 PM - Thread Starter
 
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Thanks everyone for posting.

I was initially told to come in immediately if my water breaks because they were concerned about cord prolapse. But now it seems (depending on with whom I'm speaking) that that is not such a concern! So, my current plan is to go back to my original plan -- a nice, easy VBAC.
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#9 of 9 Old 10-08-2009, 05:39 PM
 
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Polyhydraminos is a risk factor for prolapsed cord.

When I was pregnant with DD in 2005 I was talked into a primary c-section because of fetal macrosomia (she was 9lb8.5oz) and polyhydraminos (AFI=25). They thought these were a sign they had missed GD (my GTT was 67 so I doubt it).
When I was dealing with that situation, someone on here suggested that I cut out all sugars and refined flours from my diet. I did. I had a subsequent U/S for a BPP while waiting for my c-section. I wasn't told then, but I did find out from my records that my AFI was down to 21 at that point (within the range of "normal" which is 12-24). This change happened in two or three days. Having a lot of fluid helps keep the baby floating, which is one of the reasons I think that DD never dropped.
Good luck with your VBAC plans!!!!
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