leaking amniotic fluid in 2nd trimester

Hey Naaz

Just wanted to check in and find out how you're doing xx

Yes, it is different in other countries. In UK and US they consider viability from 24 weeks and will do all they can to help / revive a baby born from 24 weeks onwards. In SA government hospital viability I think is only from about 28 weeks, but private practice doctors see it as from 26 weeks. Before that though it doesn't mean that they totally won't do anything at all. Before 26 weeks they treat each case individually. Once the baby is born they do a viability test which is similar to the apgar test but includes things like: is the baby's heart beating when born? Is the baby attempting to breathe at all?
With my son his heart was beating but his lungs were still hard like little rocks, so he was classed as not yet viable. But if there is even the slightest chance that the baby can survive with help they will help them.

My aunt volunteers at Tygerberg hospital with her church and she frequently visits the neonatal units and has seen babies weighing only 500g that have survived and there was actually one baby born at 22 weeks that survived. It is extremely rare at that young age, but it has happened, in SA.

The reality of it all is that there is a fairly high chance that things probably won't end well. But it's not 100% chance. There is still a chance, albeit a smallish one, of it all having a happy ending.

I definitely understand what you mean when you say you don't want false hope only to be hit sharp and hard though. I clung to every positive story possible, especially as I was already 24 weeks, and yet it still ended badly for me, and it really did hurt like mad, more than most people can even imagine. But now, almost 2 years later (my son's birthday will be next week) it is much easier to talk about and much easier to deal with. The pain will never go away entirely, and those memories will always be there, but one learns to move through it and to keep on living. Life changes, I have changed enormously, but you learn to live with that new life and to make the best of it.
And I have been blessed with a second son who is now 19 months old and he is the absolute light of my life and just brings so much joy and happiness which definitely helps to dilute the immense sadness I felt 2 years ago.

It's a hard road to travel and one I really hope you don't land up going down, but if you do I just want to assure that it does get easier over time.

For now though, take each day at a time. As long as contractions don't start, and as long as your temperature stays down, there is still hope xx

@ huggles - thank u but ANY info regarding this matter is most appreciated!

I have also checked online and all of the positive outcomes comes from UK based blogs and here in SA its not the same. I thought there would be someone from home ground that had an experience that they could share seeing as legislation totally differs to other countries ... I'm not being negative but trying to be realistic about my situation. I don't want to be on false hopes and then only to be hit sharp and hard

This website has a number of people talking about their positive outcomes.

I just need to add though that it's a UK website. Viability in SA is only considered as 26 weeks, not 24 weeks like UK, although between 24-26 weeks they do a viability test once the baby is born to see whether or not they are able to manage with some assistance.

www.babycenter.com/400_membrane-rupture-...to-yo_3340747_343.bc

I've been looking for some positive outcome stories for you and I really liked this one:

[NST = non-stress test]

I have a positive story for you. I pprom'd at 21w3d with my dd. I was immediately admitted to the hospital. I had no measurable fluid. The doctors were very gloom and doom. Saying that I would like start contrations or get an infection within in a few days. The told me they would transfer me to another hospital if we wanted to induce then, I was at a catholic hospital and they do not do that. We decided that we would take it day by day and as long as she had a heartbeat we would continue. I got heavy doses of IV antibiotic that night and for the next week. At first they didn't really monitor the baby except by doppler once a day. I got an u/s once a week until 24w. After 24w, I got NST's every 12 hours and weekly u/s. I never had measurable fluid around her. I continued to leak all the time, which the doctors said was very encouraging. I was drinking one gallon of water every day. The did say that she had a very small chance that her lungs would be developed enough to allow her to breath after birth.

I stayed in the hospital for 93 days. I delivered her at 34w1d. We were already scheduled for a c/s the next day, but I started having some irregular contractions and it freaked my ob out and he said enough is enough an we would deliver that night after his office hours. The plan all along was to make it to 34w. He said the risks outweighed the benefits at that point. Quite honestly I was ready. It was a long 13w.

She came out crying and breathing on room air. I think her apgars were 9 and 8. She did go to the special care unit. She ended up needing some oxygen via nasal cannula a few hours later. But never had to have c-pap or be in tubated. And NO nicu time. She did stay in special care for 12 days and came home on a small amount of oxygen, but only for 6w.
She is now 20 months and a feisty as can be. No problems, infact she has only been sick with 1 cold and she did get RSV last winter but that's a whole story in and of itself. She is hitting all her milestones right on, we don't even adjust for her preemie age.

My advice is to go with your gut. Take it one day at a time. I had a dry erase board in my room. At first I would just count down the weeks, then when I got to about 30w, I started to write how many days I had been there and how many more to go to get to 34w. A few of the doctors didn't like that. My DH said that maybe they felt more pressure because it made them realize how much time was invested. I dunno. It made me more motivated, I had an end in sight.

www.fertilethoughts.com/forums/bed-rest-...uid-around-baby.html

Will see if I can find some others and will post them over the next few posts.

Also, don't bath at all. If you really feel you need to have a quick scrub then shower. You don't want anything to be able to get inside to the womb. Try and stay lying down as flat as possible as much as possible as that takes the pressure off your cervix and might allow the membranes to heal a little more easily.
And lastly (sorry, a little tmi), when you use the loo be sure to wipe front to back as that would be another potential way for germs/bacteria to get into the womb.

argh, I just typed up a whole reply and the internet ate it!

I've never heard of the sac dividing before, and after a quick google I didn't come up with anything either, so I'm not really sure what it is they mean when they say that.

Regarding infection, my membranes did get infected after they ruptured, but it was all contained within the membranes and placenta so as soon as they were delivered the infection was out of my body. I never needed antibiotics or anything. So just because infection is a possibility does not mean that it will get as bad as needing a full hysterectomy. All they did with me was to keep a close eye on my temperature the whole time I was in hospital, as an increased temp will be the first sign that infection has set in in your own body.

If that happens, you are well within your rights to request antibiotics and to wait a further 12 or 24 hours to see what happens, rather than terminating. They cannot force you to do something against your will. But as long as you yourself do not have an increased temperature at all I definitely wouldn't let them bully you into terminating.

From past experience and from things I've read from other people, generally if the membranes are completely ruptured and it is not possible for them to repair themselves you will most likely go into labour naturally within 24-48 hours.
It's most definitely not what you want to happen, nor is it a nice thing in any way, but at least it is nature taking it's course and not you having to make the decision to end things. It's not easy either way though.

However, if the tear is a smallish one then there is every possibility that it will and can repair itself, and if it does then your body constantly produces amniotic fluid so that sac will refill with fluid.
If that happens, I would speak to your doctor about whether or not a course of antibiotics would help any potential infection within the amniotic sac / placenta. It is then very possible for your pregnancy to continue further.