Pregnant After PROM (PAP) Guidelines
Whether you are preparing to be pregnant after PROM (PAP), or you're already PAP (and if you're already PAP, congratulations!), you probably have many questions about how you and your health care team can best manage a PAP pregnancy. The members of the PROM list have created these PAP guidelines using our own experiences and research to help you and your health care team minimize the possibility of repeat PROM, and maximize the opportunities for carrying your baby or babies to term.
Many health care practitioners believe that PROM is a "fluke" -- especially if there were no signs of cervical weakness or infection at the time the rupture occurred. Your practitioner may believe that the odds of experiencing repeat PROM are very, very low, and might not recommend any changes to your management, monitoring, testing, or activity in your PAP pregnancy.
It is true that the odds are good that you will not PROM again, even without making any changes in how you manage your PAP pregnancy. Many members of the PROM list have had successful PAP pregnancies by following only some of the PAP guidelines listed in this article -- or none at all -- according to what was appropriate or realistic to their circumstances.
However, you should also know that many women do experience repeat PROM. Because the possibility of repeat PROM does exist, we thought it would be useful to put together a comprehensive list of PAP precautions. Much of the information in this article reflects what the PROM list members have learned from their PAP pregnancies, and what they found helpful for identifying potential problems.
This article presents a very conservative approach to managing a PAP pregnancy, and will be especially useful for women who would like to feel that they are doing everything in their power to avoid a repeat PROM. Keep in mind however, that these guidelines are not "one size fits all." Because a PROM-free pregnancy is not guaranteed even if you follow every one of these guidelines exactly, some women will opt for additional precautions on top of what is in this article. Other women may find that the PAP guidelines require a level of caution that is not appropriate or realistic to their situation and may choose to follow only some or none of these guidelines. Since you know your body better than even your doctor, it is only appropriate that where your pregnancy is concerned, you do what works best for you.
The key is to find what works for your own peace of mind. Print out this article, discuss the PAP guidelines with your health care practitioner and your family, and adapt them to your needs and constraints, especially if you have small children who require your help and supervision.
If at any time during your PAP pregnancy you have the sense that something is wrong, including signs of preterm labor, contact your health care practitioner immediately. For a description of the symptoms of preterm labor see the March of Dimes website: [http://www.marchofdimes.com/pnhec/188_1080.asp].
This article provides primarily practical information and doesn't address the
anxiety and other emotional challenges that often accompany a high-risk pregnancy.
We invite you to join the PROM list so that we can provide emotional support
through your PAP pregnancy, and share our experiences with you. We've also included
some online and book resources at the end of this article that can help you
and your family cope during your PAP pregnancy.
Article by Kay Squires & Holly Norman, january 2005
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