Amniotic Membrane Repair and Fluid Infusion After Water Break?

Q: Amniotic Membrane Repair and Fluid Infusion After Water Break?

Peace： Your issue is not solely related to ruptured membranes; it also involves cervical structural instability. <br>Essentially, amniotic membrane repair requires specific conditions： for example, the uterine cavity must be confirmed to be free of infection, and the cervical str

Is it appropriate to perform amniotic membrane repair and amniotic fluid infusion after the rupture of membranes?

Hello Doctor,
I would like to ask for your advice.
I underwent a McDonald cerclage at 16 weeks, and at 20 weeks, I experienced cervical softening with slight bleeding, and the amniotic sac had descended into the vagina.
I underwent another suturing procedure immediately.
However, the following morning after the surgery, my amniotic fluid ruptured, and I have been experiencing some bleeding mixed with amniotic fluid daily.
After five days, an ultrasound revealed that there was no amniotic fluid left! Currently, I am at 21 weeks and 1 day, with no signs of infection, but occasionally, a small amount of amniotic fluid is leaking out, accompanied by a trace of bleeding.
I do not want to give up; I want to do everything possible to save my baby.
I am seeking more aggressive treatment options rather than just lying down, receiving antibiotics, and taking medications to prevent miscarriage.
I would like to know if it would be appropriate for me to transfer to your facility for amniotic membrane repair and amnioinfusion.
Thank you!

Lu Mama, 40~49 year old female. Ask Date: 2018/01/02

Dr. Chen Ming reply Rare Disease

Peace: Your issue is not solely related to ruptured membranes; it also involves cervical structural instability.
Essentially, amniotic membrane repair requires specific conditions: for example, the uterine cavity must be confirmed to be free of infection, and the cervical structure must be stable (to prevent maternal sepsis or membrane bulging as gestational age increases with increased amniotic fluid).
In unstable conditions, it is generally not recommended for you to move, as it increases the risk.
May God bless you!

Reply Date: 2018/01/02

More Info

Amniotic membrane repair and fluid infusion after a rupture of membranes is a complex situation that requires careful consideration and management. Given your history of cervical incompetence and the recent events surrounding your pregnancy, it is crucial to approach this matter with both urgency and caution.

Firstly, it is important to understand that the amniotic sac plays a vital role in protecting the fetus and providing the necessary environment for its development. When the membranes rupture, as in your case, the risk of complications increases significantly, including infection, preterm labor, and potential harm to the fetus. The fact that you have experienced a significant loss of amniotic fluid and are still having some bleeding is concerning and warrants immediate medical attention.

In your situation, the primary goal is to prolong the pregnancy as much as possible while ensuring the safety of both you and your baby. The management of ruptured membranes often involves a combination of monitoring and intervention. Since you mentioned that you are not experiencing any signs of infection, this is a positive aspect, but it does not eliminate the need for careful observation.

Regarding your question about amniotic membrane repair and fluid infusion, this procedure is typically performed in specialized settings, such as a high-risk obstetric unit. The decision to proceed with such interventions depends on several factors, including the gestational age of the fetus, the amount of remaining amniotic fluid, the presence of any infections, and the overall health of both you and the baby.

If you are considering transferring to a facility that can provide more advanced care, it is essential to discuss this with your current healthcare provider. They can help assess your situation and determine the best course of action. In some cases, if the fetus is viable and there are no contraindications, a procedure to repair the membranes and infuse fluid may be considered. This can help cushion the fetus and potentially improve outcomes.

In addition to surgical options, it is also important to continue with supportive care. This includes hydration, monitoring for signs of infection, and possibly the use of medications to help manage contractions and support the pregnancy. Bed rest may also be recommended to reduce the risk of further complications.

Lastly, emotional support is crucial during this challenging time. It can be incredibly stressful to navigate a high-risk pregnancy, and seeking support from healthcare professionals, family, and friends can be beneficial.

In summary, your situation requires a multidisciplinary approach involving obstetricians, maternal-fetal medicine specialists, and possibly other healthcare providers. It is essential to have open communication with your medical team about your concerns and preferences. If you feel that a transfer to a facility with more specialized care is necessary, do not hesitate to advocate for yourself and your baby. Your desire to do everything possible to protect your child is commendable, and with the right support and interventions, there may still be options available to you.

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