At 17 weeks, I was visiting my sisters
in Phoenix and my brother-in-law
(massage therapist) gave me a body
massage. He was not specifically
trained in pregnancy massage, and I
later learned that massaging the feet
and ankles can stimulate labor. I
don't know if this was related to my
rupture, (I certainly don’t blame
him!!) but it did happen the next
morning (just for your
information).
I had bleeding starting at about 11
weeks, but no specific issues. When I
suddenly produced an abnormal amount
of brown fluid – very watery
(overflowing a maxi pad and wetting my
pants over a period of 1.5 hours) I
called my doctor. He apparently
thought I was bleeding again and told
me that if it continued that heavily
into the evening, I should go to the
hospital. He said that if it stopped,
I was probably okay. I don’t think he
considered PROM. Well, it stopped and
so I didn't think much of it until 4
weeks later at a regular
exam/ultrasound. This was also
careless on my part, but I had not
idea you could rupture that
early.
I was now 21 weeks and was informed
that I had no fluid (less than 1 AFI).
They advised bed rest at home until 24
weeks when the baby was considered
viable. We also spoke with a
neonatologist who showed us some
statistics of 100% mortality rate for
PROM and he suggested that we consider
terminating the pregnancy. They said
she would probably be born and maybe
live 2 hours at the most. After this
conversation, my husband and I just
couldn’t believe that there was
nothing the doctors could do... with
all our amazing advances in modern
medicine!! So we went home and my
husband got on the WebMD website and
found out about amnioinfusion. We went
back to the doctor the next Monday and
asked him why he hadn’t mentioned it.
He said it was hospital protocol to
administer amnioinfusion within one
week of the rupture. He also said that
if we wanted to specifically request
it, he would try it, even though it
had already been over 4 weeks (with no
infection or miscarriage). We made two
attempts (four days apart) and checked
me into the hospital after the second
infusion. I was almost 24 weeks by
this point. The amnioinfusion had
apparently not been successful –
according to the ultrasounds I did not
retain the pockets of fluid that the
doctor put in (at least 250 ml each
time!!). My AFI dropped back to 1 or 2
within 24 hours after each infusion. I
argued with the doctor that no fluid
had come out of me (I would have felt
myself lose that amount of fluid – and
I was wearing a pad that stayed dry),
but he said because of the risk of
infection and starting labor, he
didn’t advise continuing to try based
on the results he could see in the
ultrasound. I WOULD ADVISE ANY WOMAN
TO TRY THIS METHOD IF IT IS AVAILABLE
TO YOU. I still think my body retained
some of the fluid and that is what
saved my daughter’s life.
During this entire ordeal, our baby’s
head was down and the doctors said
that hopefully she was breathing any
tiny bit of fluid that might be near
my cervix. She stayed in this position
until she was born. I remained on bed
rest for over 5 weeks in the hospital
(luckily no IV) and took only some
antibiotics to help prevent infection.
I did have a few scary moments where I
felt some contractions at about 25
weeks, but they started me on a mild
muscle relaxer to control the
contractions (pill form – Procardia).
I stayed on these until the real labor
began.
I was told that the baby probably
wouldn’t be able to tolerate natural
delivery, so I would probably have to
have a cesarean section (something I
was adamantly opposed to). Four days
before my 30th week, I started very
strong labor pains. They progressed
quickly and they took me back into the
monitoring area, put me on magnesium
sulfate and began 24 hour monitoring.
From this point on, my husband didn’t
sleep a wink. He was fixated on the
monitor. The next morning, they
thought they had the contractions
under control (I was unable to focus
or function well on the magnesium –
nasty stuff!!) and they sent me back
to my room. At 5:30pm the next
evening, the labor started very heavy
again and we called in my doula.
Somewhere around 6:30 or 7pm (I wasn’t
really watching the clock!!) I could
feel the baby move down. At this
point, the doctors still had me in
the “monitoring room” and were still
trying to decide whether they were
going to try to stop my labor. I told
them there was no going back and she
was coming out!! I was very lucky to
deliver naturally – 4 or 5 pushes and
she was out!! She weighed only 3
pounds and was 15.5 inches long. They
immediately rushed her out of the room
(okay by me!!) and took care of her.
They brought her back in about 20
minutes later hand-bagging her (so she
could breathe) so that I could see
her, but we told them to get out and
get her stabilized!! They had
previously told us that if they could
get her to process any oxygen at all,
they would transfer her to a higher
level facility. If not, they would
give her to us to hold her for her
short life. After about an hour, they
said they would be transferring her to
the children’s hospital. At that point
I thanked God, because knew she at
least had a chance of living.
We got to see Lisette about 1.5 hours
after she was born. She was connected
to a respirator (down her throat) and
was not really responsive. She was so
tiny and frail and extremely bruised.
Her head was totally purple, probably
from being stuck in my cervix for so
long. She was moving her little arms a
legs a bit, and we were immediately in
love. They took her to the children’s
hospital during the night. My husband
followed her over there and I checked
out the next morning. During the
night, my husband relayed what they
were doing to try to save her life...
here’s some of the detail he wrote
around the third day after her
birth:
Her underdeveloped lungs are the
biggest concern and she initially had
problems getting enough oxygen to keep
her blood saturated. She has both
pulmonary hypoplasia and hypotension.
They have her on a high pressure
ventilator that is providing oxygen
for her. They're also giving her
nitric oxide (NO) to help dilate the
capillaries in her lungs to get
maximum oxygenation to her blood.
Unfortunately, although necessary in
the short term, the high pressure can
cause damage to her lung tissues and
puts her at a higher risk for chronic
lung disease in the future. Monday
afternoon she collapsed a lung because
of the pressure and they had to insert
a tube into her chest cavity to
relieve the pressure caused by the
leaking lung. Fortunately, after they
put the chest tube in, she made a
wonderful turn towards improvement.
She's still on the ventilator, but
they've been able to cut the pressure
down almost in half. They've also been
able to dial down the percentage of
oxygen in her ventilator from 100% to
58% (they'd like to get it down to as
close to normal (21%) as possible).
They've also noticed that she's out
breathing the ventilator which means
that she's sneaking in a few breaths
on her own and they've turned down the
number of breaths per minute the
ventilator puts out to less than 20
(down from 60). They're still giving
her NO and will continue that until
her oxygen comes down a bit more. Just
this afternoon they took the chest
tube out and she's no longer leaking
air (by chest x-ray). The fact that
she was able to repair the leak that
quickly is a good sign. They've been
drawing blood on a regular basis to
assess her blood gas levels. They use
this information to determine the rate
at which they can wean her off of the
ventilation support. As a result,
she's been given 2 transfusions (15mls
each) to replenish her hemoglobin
levels. She also has a central line in
her umbilical vein where she gets her
nutrients (glucose and electrolytes
for now). On Wednesday they did a head
ultrasound that came back normal. They
initially had her on both dopamine,
dobutamine to get her blood pressure
up and they also had her on a course
of hydrocortisone for her blood
pressure and to stimulate lung
development. Fortunately, they've been
able to wean her off of all of these
and her blood pressure is now stable
and looking good. She's no longer
considered hypotensive.
They tried the regular respirator, the
high-speed oscillating respirator and
they even hand-bagged her for 5 hours
(all the nurses taking turns!). They
were amazing. At about 7am they added
NITRIC OXID to her oxygen and suddenly
her oxygen levels flew up!! THAT WAS
THE KEY. THAT SAVED HER LIFE. We later
found out that 10 or 15 years ago she
would not have survived. It also
turned out that the statistics that
the neonatologist gave us were 10
YEARS OLD!!!
SO DON’T GIVE UP. MODERN MEDICINE
(WITH THE HELP OF GOD, OF COURSE) CAN
DO WONDERFUL THINGS. REMEMBER THAT MY
AFI WAS LESS THAN 2 AND I RUPTURED AT
17 WEEKS!!
Lisette was on a respirator for 1.5
weeks, then a CPAP (pressurized nasal
tube) for 4 more days. I didn’t get to
hold her for the first week and a
half. After two weeks, she was
transferred out of intensive care and
into the special care nursery with
just a nasal canula with some extra
oxygen. They had started giving her
breast milk on day 2 after her birth
(through a feeding tube) and then I
began breastfeeding in the hospital at
about 5 weeks. We used a combination
of breast and bottle from then on, but
mostly breast once she came home.
She remained in the hospital 9 weeks
(came home one week before her due
date – fairly typical). When she did
come home, she was still on extra
oxygen (we had a huge tank and a 50
foot tube to carry her around the
house) and a heart/breath monitor for
another 7 weeks. THE ONLY REAL
PHYSICAL ISSUE SHE HAD WAS SEVERLY
UNDERDEVELOPED LUNGS. Other than that,
she developed amazingly quickly and
well during her stay at the hospital.
At every return visit to the doctors
for follow-up exams, they would tell
us how they were still discussing her
case and how amazing and miraculous it
was. I think they learned a lot from
Lisette and I’m glad they can save
other babies’ lives with this
knowledge!!
The doctors who took care of me also
learned a lot about what is possible.
Luckily, two of the doctors at my
hospital had reassured me that they
had a very few similar cases
previously who also had babies who
survived. They gave her a 2-5% chance
of survival. Then I also found this
website while I was on bed rest at the
hospital. I immediately gave it to the
doctors. It really kept me going and
believing that our baby could
live.
Lisette just turned two years old and
is a totally normal, feisty little
toddler. She is absolutely beautiful
and loves to sing and dance. (We
played music for her in the womb and
in her hospital bed during her entire
stay.) I am convinced that she has a
special purpose in this world.
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