PPROM'd 28w4d + Strep B positive - Induce or c-sec?

[proxile]

During my 3 days stay at the hospital at 28w4d, I have been given antibiotics pill (for Strep B infection) and steroid (for baby's lungs). I was sent home due to no signs of labor.

I'm currently 32w2d. Since the PPROM incident, it is safe to say that it did not happen anymore (so far). Hospital checkup shows that my amniotic fluid level is good, baby is active, blood test clears and stable (no signs of infection), no fever, and have been monitoring my discharge daily. Baby are currently at 1.8-2kg (which is a big win for me at the moment).

I have been given 2 options here,

1. induce at 34w due to PPROM and Strep B positive - cons: baby might go into NICU
2. close monitoring by the specialist during 34-36w followed by elective c-sec, max at 36w - cons: risk of infection to the baby due to Strep B positive
3. [another is, if labor suddenly happens before 34w then it depends on the situation - normal delivery/emergency c-sec]

Given with my current condition, I am inclined towards option 2. I feel fine, baby is active, I don't feel sick, no water/discharge, amniotic fluid level is good. But what are the chances if I extend another week or 2 that my baby might get infection from Strep B? As a FTM that's experiencing PPROM, I really hope I don't have to go through a NICU baby.

Is it too dangerous to let my body carry my baby for another week or 2 due to my condition? If c-sec would reduce the risk of infection to my baby, I'm willing to make that decision. Thoughts?

 

[maddad]

@proxile I hate to break it to you but any baby can go to the NICU at any time, further along in gestation it’s less likely but 36 week old babies go to the NICU all the time or are totally fine with mom at bedside. Just so many circumstances.

I think all of these options are fine options but personally, I would just go option 1. 2 weeks doesn’t make a hugeee difference.

I work in mother baby and honestly it’s likely your baby at 34 weeks could be totally fine with very minimal NICU time. Every baby is different but I would personally not risk infection for me personally waiting the extra 2 weeks gestation.

This is a very personal choice and I think everybody will have a different opinion on this but I always say less risk the better especially when it comes to infections. Sepsis can hit very quickly and there can be very grim results for mom and baby. I would also listen to your providers and what they recommend of course.

 

[maddad]

My concern isn’t the strep B, more so the PPROM fyi

 

[relle25]

@proxile I was strep B positive and had PPROM in week 36 with my third baby so I did end up with a pitocin induction (wasn't progressing). So not the same scenario as I was way further along, but I did have those two factors. What is your care team recommending? Are they leaving the decision completely up to you? I guess I'm a bit confused that induction at 34 weeks would be fine but it would have to be a C-section anything slightly past that. Could you have them clarify that part for you? The other confusing part is that there would still be a NICU risk in either option 1 or option 2 regardless (many babies at 35 or 36 weeks don't need NICU time, that's true, but many still do).