[valene]

on those rare occasions that membranes are intact when the patient is complete, would you encourage pushing? something in the back of my mind says no? amnioitic fluid emboli risk? risk of delivering with bag of water over the baby head (aspiration)?
what do you all think?

[acuteobrn]

From what I have experienced most OBs AROM or pts SROM on their own. If the OB is in house I don't ever remember them not AROMing the patient. I had a pt the other night who walked in complete and intact, was pushing and OB showed up AROM and delivered w/ next push. I don't know if pushing while intact would cause a AI, from what I understand of the physiology is caused by a break in the placental vasculature system allowing fluid to travel into maternal vasculature. That doesn't necessarily happen when pushing. Baby's delivered en cul (sp?) ie the BOW intact, is very rare, and as long as it is ruptured immediately the risk of aspiration is about the same as a c/s birth. I would assume that the pressure of delivery would rupture the sac spontaneously. As a side note is it considered to be good fortune for a baby to be born en cul.

[Browneyedgirl]

I had my 2nd daughter with membranes intact. They broke just as her shoulders reached my pernium.....no problems

[BETSRN]

Baby's delivered en cul (sp?) >>
That's "in the caul".

[mother/babyRN]

Ah yes, the caul.....Sometimes there isn't any reason to rupture membranes......No big deal....Unless, of course,there is a problem or major discomfort for the patient....You sort of peel the membranes off the baby...In some cultures,that is a big deal....Interesting read when it pertains to cultures and what they consider good and bad luck...

[acuteobrn]

Ahh, the caul...

Never said I could spell

Thanks Besty & MBURN!!!!!

I love to read about cultural differences in healthcare...very interesting to me...like placentas, heard and read some interesting things about what certain cultures do with em!

[dawngloves]

Not to change the subject....
A local hospital here used to give cauls to the Naval Yard.
It's good luck to have them on a ship.
Don't ask. I have no idea!

[SmilingBluEyes]

ick.

[trogdor]

I had one OB when I was new who refused to wake up and rupture my pt's membranes, even when she was complete. I remember sitting at the end of her bed coaching her pushing and wishing that I had worn rain gear as this giant water balloon was crowning.

[talldollNYC]

Yes! My mom's family all worked on ships - my grandma always told us that a caul would keep sailors from drowning. Her husband - my grandpa - had his OWN caul. His mom had saved it from when he was born. It was all dried up and he wore it in a bag around his neck. He said that it made him drown-proof. I guess it worked (he died from a heart attack.)
funny, eh?