This was my 2nd pregnancy. My first
had been trouble free with a vaginal
delivery. We had been trying to
conceive (not too hard) for nearly 3
years and had accepted we were not to
be blessed with another child when the
hpt was positive, we were both
surprised but happy. I'm not sure
exactly when, but on one or two
occasions after sex I noticed a little
blood present, just a little pink
tinge. It disappeared within a few
hours so I did nothing, assuming it
was just cervical erosion. I mentioned
this to the midwife @ my 13w
appointment, as the blood was
appearing more often and seemed to be
more like light spotting. She took a
HVS which came back clear as did the
following MSU for chlamydia. At 17w+3
there was a lot of brown coloured
mucus on waking and with hindsight I
wonder if this was my mucus plug, but
nobody has been able to answer that
question. On waking from an afternoon
nap, the following day there was more
blood present on wiping. I attended
the pregnancy assessment centre @ the
local hospital and a cervical polyp
was found. With a belly US scan the
baby was fine, with plenty fluid, and
the placenta was high and to the
front. As I'm rhesus negative I was
given a shot of anti-D just in case. 4
days later after more fresh blood on
waking the polyp was removed without
the aid of colposcopy. Histology
results on the polyp later came back
normal.There was not much blood
afterwards and I assumed things were
settling down. 2 days later there was
a little more fresh blood, but not as
heavy as a period. As it was a Sunday
and assuming it was from the site of
the polyp I did nothing. That night my
uterus was a little tender to touch,
but this had gone when I woke. The
following morning after passing a clot
I was back at the hospital and on
examination they could not see where
the blood was coming from, so I was
admitted for observation and yet
another shot of anti-D. Since the US
scan 6 days earlier had shown no
problems with the placenta it was not
repeated. Later that afternoon, as I
got up from the bed to go to the
toilet, my membranes ruptured. Now I
was leaking bloody fluid and I was
given an oral antibiotic
(erythromycin). US scan the following
day confirmed that the baby now had no
amniotic fluid. A more detailed scan 2
days later (now @ 19w) confirmed the
absence of fluid but the Doppler
showed good blood flow through the
cord. The next morning, the bloody
fluid stopped for a few hours, so it
was suggested I try lying with legs
elevated, as this seemed to help in
some cases of rupture after
amniocentesis. Willing to try anything
I agreed to give it a go and spent the
most uncomfortable 24h wearing a pair
of TEDS lying flat on my back praying.
All of the HVS taken at this point (3
I think) came back clear with no sign
of infection, but from the blood tests
C-reactive protein level had started
to rise and was I advised to consider
inducing a termination as the baby
would probably have very under-
developed lungs and minimal chance of
survival. After much soul searching
and a tearful discussion with my
husband we opted to induce. On
examination, the cord was found to
have popped out the cervix and the
baby now had no chance. We had to wait
over 2 hours, until a delivery room
and midwife were free, before I was
moved to the labour suite. A
prostaglandin pessary was inserted.
With my first labour I found the early
stages were characterised by the need
to have frequent bowel movements,
uncomfortable but not paticulary
painful. This labour was no different.
After just over 1 hour while sitting
on the toilet the baby was born, too
fast for me to catch and as the
midwives were in the middle of a shift
changeover, they were caught unawares
as well. After helping me back to bed,
the cord was cut. The baby looked to
be male, so we called him Jonathan and
we were left alone with him until a
theatre became available because the
placenta would not separate. When I
came round from the general
anaesthetic, my husband went home to
bed and I spent a most uncomfortable
night on the delivery couch, still
wearing my by now, very bloody TEDS.
The following morning more blood was
taken and another shot of anti-D given
before I was released. 5 days later
there was a phone call from the
midwife, at the post mortem he was
really a she. So we had to think of
another name for our baby. My husband
suggested Lesley, as this was the name
his mother had picked for him because
she was convinced she was having a
girl. The blood tests came back clear,
there was no identifiable infective
agents present. The post mortem on
Lesley showed she was normal for her
gestational age. There were definite
signs of chorioamnionitis, but this
was expected due to the rising CRP
levels. Whether this caused the
rupture or happened afterwards they
could not tell. They felt, on the
balance of probabilities, that the
cause was an infection, even though at
no point were they able to culture
anything from the vaginal swabs that
were taken over 5/6 weeks.
This means my next pregnancy will be
treated as high risk, but as they
don't know the cause of the pPROM,
they don't know what treatment they
will advise.
It is now 10 weeks since the membranes
ruptured and we have decided to try
for another baby. I will be 40 in just
over 2 months and I feel I don't have
any more time to waste, if I want to
give my son a sibling.
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