Arom's Potential Risks: What You Need To Know

Aromatherapy is a popular wellness trend that involves the use of aromatic plant oils, including essential oils, to promote psychological and physical wellbeing. While aromatherapy is believed to offer various benefits, it is important to be aware of potential risks associated with its practice. The main risks of aromatherapy include skin irritation, respiratory symptoms, endocrine disruption, and allergic reactions.

Essential oils are highly concentrated and should never be swallowed or applied undiluted to the skin. Some oils can cause skin irritation, such as rash, itchy and watery eyes, runny nose, sneezing, and swelling. Inhalation of vaporizing oils may trigger respiratory issues, especially for individuals with asthma or those prone to nosebleeds. Certain essential oils, such as lavender and tea tree oil, are also known endocrine disruptors, which can interfere with hormone production and lead to complications, especially in children and teens. Additionally, essential oils can cause allergic reactions, with symptoms such as itchy and watery eyes, runny nose, sneezing, and dermatological issues like redness and hives.

Furthermore, some aromatic plant oils are toxic and should be avoided altogether. Examples include camphor, pennyroyal, and wintergreen. It is crucial to purchase essential oils from reputable sources, store them safely out of reach of children and pets, and always conduct a patch test before topical application.

Umbilical cord prolapse

There are two types of umbilical cord prolapse: occult (incomplete) and overt (complete). Occult cord prolapse occurs when the umbilical cord descends alongside the baby but does not go past them, while overt cord prolapse happens when the cord descends past the baby and is lower than them in the pelvis. Cord presentation, where the cord is between the baby and the cervix, can occur with or without intact membranes.

The main risk factors for umbilical cord prolapse include:

• Breech presentation, especially in a footling breech, where the cord can easily slip past the baby's feet.
• Unstable lie, where the baby's presentation changes between transverse, oblique, or breech positions.
• Artificial rupture of membranes, particularly when the baby's head is high in the pelvis.
• Polyhydramnios, or excessive amniotic fluid around the baby.

To relieve pressure on the cord, the mother should be encouraged to lie on her left side with her head down and a pillow placed under her left hip, or in a knee-chest position. Tocolysis may also be considered if delivery is not immediately available, as it relaxes the uterus and stops contractions. Delivery typically occurs via emergency Caesarean section, but vaginal or instrumental delivery may be attempted if the mother is fully dilated and vaginal delivery appears imminent.

Umbilical cord compression

The umbilical cord can become compressed for several reasons, including:

• Baby's positioning or movement: The umbilical cord can be compressed due to the fetus's hyperactivity in the womb, especially during the later stages of pregnancy.
• Uterine contractions: Normal contractions during labour can flatten or press against the umbilical cord.
• Umbilical cord prolapse: In rare cases, the umbilical cord may drop into the birth canal before the baby, causing cord compression.
• Nuchal cord: In up to 29% of pregnancies, the umbilical cord wraps around the baby's neck, leading to mild or, rarely, serious compression.
• Knotted cord: The umbilical cord can become knotted, especially if it is abnormally long, and cause compression if the knots are too tight.

There may be no obvious signs of umbilical cord compression, but some potential indicators include decreased fetal movement or, conversely, increased fetal activity as the baby tries to relieve the compression.

The risk factors for umbilical cord compression include multiple gestations (twins, triplets, etc.), an unusually long umbilical cord, excessive amniotic fluid, breech delivery, and certain positions of the fetus in the womb, such as an unstable or oblique lie.

The dangers of umbilical cord compression include restricting oxygen and blood flow to the baby, leading to fetal malnourishment, brain damage, behavioural disorders, fetal heart abnormalities, and poor physical development. In severe cases, emergency C-section delivery may be required to prevent permanent damage or even death.

Increased risk of C-section

The potential risks of an artificial rupture of membranes (AROM) or amniotomy include an increased risk of an emergency caesarean section. This is primarily due to the baby being in a breech position after the amniotic sac is ruptured.

Risks and Complications

The risks and complications of an AROM that can lead to an emergency C-section include umbilical cord prolapse and compression, which can restrict the baby's oxygen supply. In addition, there is an increased risk of intrauterine infection, and the risk increases with the duration of the membrane rupture.

Prevention

To prevent an emergency C-section, an AROM should only be performed when the fetal vertex is well-applied to the cervix, and the baby is in a head-first position in the birth canal. It is also important to ensure that the cervix is softened or thinned and that the baby's head is in the correct position, low in the pelvis, and pressed against the cervix.

Timing

The timing of the AROM is crucial as well. Performing an AROM at 4 cm dilation may shorten the time to delivery without increasing the risk of infection. However, an earlier rupture of membranes can lead to a longer exposure to ruptured membranes during labour, potentially increasing the risk of infection.

Alternative Methods

In some cases, an AROM may not be ideal, and alternative methods may be considered. For example, a natural labour progression may be preferred in low-risk pregnancies. Additionally, the combination of amniotomy and intravenous oxytocin is more effective than amniotomy alone and may reduce the need for a C-section.

Infection

It is important to note that the potential for infection at intrauterine sites did not have a linear relationship with the mean membrane rupture-delivery interval or the number of vaginal examinations.

Increased pain

AROM is performed to induce or augment labour contractions. It involves rupturing the amniotic sac, which is a fluid-filled sac that surrounds and protects the foetus during pregnancy. The procedure is typically carried out using a thin, plastic tool called an amnihook, which is inserted through the vagina to scratch or tear a hole in the amniotic sac, allowing the fluid to escape.

The effectiveness of AROM is often debated, with some studies showing that it does not advance labour in low-risk pregnancies, and that a natural progression is preferred. However, there is also data to suggest that it can speed up labour, particularly when used in conjunction with intravenous oxytocin.

There are several other risks and complications associated with AROM, including umbilical cord prolapse and compression, increased risk of infection, and placental abruption.

Frequently asked questions