出産前クリニックへ。予定日を2日過ぎているので、医者が分娩誘発(インダクション-Induction)の予約を入れた。95%の妊婦が40週と10日以内に出産するが、予定日を2週間過ぎた後から過期妊娠と呼ばれる。過期妊娠になると、胎盤の機能が低下して胎児に危険が及ぶため、その前に誘発するから通常は予定日2週間後ぐらいの予約になる。私の場合は腎臓の問題があるので念のため1週間後の27日になった。ちなみに、前期破水の場合にも施されることもあるため、平均5人に1人が分娩誘発を経験する。
27日にまだ生まれてない場合、朝から出産前病棟（この前入院した病棟）に入院し、子宮口を軟化させて陣痛を促進するジェル(prostaglandin)を投与される。それでも効かないと、分娩病棟でもっと強い誘発剤(Oxytocin)を使うことになる可能性もある。ジェル、誘発剤共に、赤ちゃんの状態が悪くなったら即帝王切開、過強陣痛の可能性あり。分娩誘発により、帝王切開、鉗子・吸引分娩はそれぞれ、通常分娩の1.8倍、1.5倍の可能性。また、誘発剤は、、子宮破裂が引き起こされ、胎児仮死のリスクもまれにあるというから怖い。もう一度よく考えて、予約をキャンセルしようかとも思っている。
一応、医者は分娩誘発の一つ、卵膜剥離を試みた。卵膜剥離では、子宮口と子宮の間に指を入れて剥離することにより、陣痛を引き起こすホルモンが誘発され、24から48時間以内に出産が始まる効果が期待される。子宮口が軟らかいと効果も大なのだが、私の場合まだあまり軟らかくなっていなく、子宮口には指の先しか入らなかったと医者に言われた。家に戻ると少し出血あり。内診のせいだが、出血を見るなんて何ヶ月ぶりかしらと思った。刺激のおかげで2,3日中に生まれるといいんだけど。
初産の場合出産が遅れがちだと言うし、母が私を出産した時は5日、弟の時は10日も遅れたらしいから、遺伝って事はないのかなあ。そういえば、Jasonも分娩誘発で生まれたらしい。遺伝的要素があるとしたら、お産はきわめて楽だったと言う母の言葉が励みだ。
Antenatal clinic. Doctor made an induction appointment for me on 27/12/04. Induction is usually arranged at about 2 weeks after the due date, as after 42 weeks, the placenta starts to deteriorate and risk of baby dying in the womb unexpectedly increases. But in my case, because doctors do not know the cause of my kidney problem, they decided to set it up only a week after the due to be on the safe side. When waters break, induction is often introduced as well, and all together induction rate is about 20%.
If he hasn't been born on the 27th, I'll need to admit to the Antenatal Ward, the one I stayed for 2 nights before, from early morning. Gel containing 'prostaglandin' is inserted into the vagina to soften and ripen the cervix. This substance stimulates the uterine contractions. If it does not work, stronger drug called Oxytocin is given through a drip in the labour ward. Both methods have a risk of the uterus to contract too much or chance of caesarian after baby's conditions deteriorate increases. 1.5 times more likely to need a forceps or ventouse delivery and 1.8 times more to need a caesarean. In addition, Oxytocin might have small risk of uterus rupture. It's scary. I need to think again if I will really go for the induction.
The doctor anyway performed a 'membrane sweep'. Membrane seep involves a doctor or midwife placing a finger just inside the cervix and making a circular, seeping movement to separate the membrane from the cervix. This method releases some sort of hormone which kicks the labour, which may starts within 24 to 48 hours. It's more effective if the cervix is already soften, but in my case, it wasn't soft enough and the doctor could only put the tip of a finger in. Anyway, after coming home, I found some spotting of blood. It's normal after membrane sweep but I was quite shocked to see blood stain after 'no periods' for so long! I hope doctor's try will stimulate labour and the baby will come out before the planned induction.
It's commonly known that labour starts later than the due for the first pregnancy. When my mum had me, I was 5 days late and my younger brother stayed inside 10 days longer. Jason was also induced. Baby overdue is running in both families? If anything to do with genes, my mum's words, 'Labour itself was always very easy for me.' is the saving grace!
No comments:
Post a Comment