What a heartbreak it is to hear
confirmation that you have ruptured.
For those who don’t go into labor
immediately there is the fear and
sense of dread that early labor is
imminent. I had that fear, and I was
extremely grateful to a group of women
who pointed me to this website where I
cried with every loss story, and was
inspired by every success.
I had a success – and with multiples
too – and I vowed to myself to take
some time to share my story, like so
many wonderful women took the time to
share their stories to help me.
Found out in week 8 I was having
twins. At week twelve we shared the
news with everyone. At week 15 I
began having bleeding episodes. Went
to my OB who said that bleeding is
normal for twin pregnancies and not to
worry, babies were fine (confirmed
with u/s). Two weeks later I was
still bleeding and not feeling very
comfortable about the bleeding so I
insisted on another appointment. They
agreed, “Just to make me feel
better.” My OB continued to downplay
the bleeding and gave me a vaginal
exam, then an u/s. During the u/s she
suddenly became grim because I had an
8 cm blood clot pushing against the
babies (who were both still fine) and
she thought I had placenta previa.
She sent me off to a perinatologist
consult. At the consult I cried
during the u/s, fearful that something
very wrong was going to be found. The
Perinatologist sounded upbeat; he saw
that the blood clot had gone down. He
suggested I come back in a month for
another u/s to check things out. Peri
also noted that I did not have
placenta previa.
Week 18 5d - I got up to go to the
bathroom and was surprised when I felt
like pee came out before I released my
bladder. I shrugged and went back to
watching TV. That night I awoke at
5am with a sense of confusion – I felt
wet. I pulled back the sheets and
confirmed that there was a puddle on
the bed. Dread shot through my
veins. I bent down and sniffed the
liquid – no scent. Ugh. I went
calmly to the bathroom and looked at
my underwear, no tinge of blood, no
smell. I decided it must be amniotic
fluid and that this probably wasn’t a
good thing, but I the severity of the
issue didn’t really hit me. I kept
thinking, “Amniotic fluid means you
ruptured and go into labor, but I am
definitely not in labor.” ??
I didn’t tell anyone and I kept an eye
on the leaking. It wasn’t continual –
it would come in squirts, and then
stop. I called the OB and explained
the situation. The gal on the phone
told me to go to the hospital, I was
in labor. Uh, I explained I was only
at 18w 5d and would prefer an office
visit as I was not in labor. I got in
the same day, was seen by an OB who
did a vaginal exam and tested for
amniotic fluid. Negative, they told
me. Just incontinence. I was
relieved but baffled. That night I
posted to an online messaging board
about how the squirts of clear fluid
frequently occurred when I sat down to
go to the bathroom…and that I was
positive the fluid was coming out
before I released my bladder. Thank
GOD for the eight or so women who
immediately posted back shouting at me
to leave my OB and go to a
perinatologist right away. It got me
in the spirit of persistence. The
next morning I called my OBs office
over and over demanding an appointment
because I was sure I had ruptured.
They wouldn’t book me an appointment.
That day I also found out I had
gestational diabetes, and that the
numbers were too high to manage the
diabetes with food/exercise so I would
be taking insulin. At 4pm I called
the office and began shouting and
crying that I needed an appointment
ASAP. They told me to come right in.
I met with a different OB who did
another test and again confirmed I was
not leaking. I stood firm and gave
her a description of what was
occurring and insisted I had PPROM.
She took pity on me and scheduled a
perinatology appointment for the very
next day.
At 19w I went in for an u/s with the
perinatologist. The u/s technician
did her thing…the babies were fine and
moving and I could see fluid around
both babies. I hoped I had made a
grave mistake. The sweet
perinatologist walked in and asked me
to again explain what I was
experiencing. Then, without doing
another of those blasted amniotic
fluid tests he simply said, “Yes,
you’ve ruptured.” I felt both
vindicated and deflated. He said I
must go on immediate strict bedrest.
But, he said he wasn’t trying to save
the babies at that point, because at
19 weeks there was no way they could
be saved. He told me his biggest
concern was my safety, because the
incidence of infection was VERY high
for rupture cases. He put me on
antibiotics for seven days. Two
different types. He also told me to
drink lots of water, and to flush my
labia with water after EVERY bathroom
visit to attempt to flush bacteria
away from the vagina. I was also to
check my temperature twice a day to
check for the possibility of a rise in
temperature – thus an infection. The
perinatologist said that if I made it
to 24 weeks (the chance the babies
would be viable) he would check me
into the hospital for the remainder of
my pregnancy.
I had weekly visits to the
perinatologist to check on the
babies. The fluid began to slowly
decrease around baby “B” each week.
Fluid levels averaged around 4-5 for
the remainder of the pregnancy.
Sometimes they dipped to 2, and one
time I got a 7. At week 22 I had a
large bleeding scare. Bright red
blood spilled out – but I told no
one. I knew I wasn’t hemorrhaging and
I didn’t want to put undo stress on my
body trying to drop everything and
rush down to the hospital 45 minutes
away, only to have to go through the
stress of hospital admittance, etc.
I figured, if one or both of the
babies wasn’t making it I would go
into labor and so be done with it.
I had my perinatology appointment two
days later and I mentioned the
bleeding episode to the u/s
technician. Though both babies ended
up looking great on the u/s, my doctor
came into the room very grim. I will
never forget that day – I thought for
sure he had horrible news for me.
Instead he just wanted me to
understand the reality of the
situation. I think what floored him
is that my attitude from the day I
found out was simply, “okay, we’ve hit
a setback, but this is all going to
turn out just fine.” I would come to
the appointments cheery and smile and
act like I was ready to be put into a
basketball game. “Okay, coach, just
tell me what to do!” I kept that
attitude throughout the pregnancy,
never surrendering myself to the
feelings of fear I had for my babies.
Not sure if that helped, but it was
the only way I could cope.
At 23w 5d I felt victorious because
there was at least a chance my babies
could survive. I arrived triumphantly
at the hospital, ready to make it to
week 32, which is as far as my
perinatologist originally told me I
could go. [Though he waffled back and
forth between 32 and 34 weeks the
entire time.]
The remaining 8 weeks of bedrest at
the hospital were horrible. Fetal
monitoring every six hours for one or
more hours was torturous. I had no
privacy because of my gestational
diabetes there was always something to
be done – shots/snacks/glucose
checks. I gushed fluid a lot during
these days, and it always made me
sad. But my perinatologist said it
was a good thing – he wanted fluid
flushing out to help keep infections
away. It was nice that he could spin
it that way. ;) Every so often I
would have a large gush of deep red
blood, but it never could be
pinpointed, and never affected the
babies.
When I hit week 30 I was in heaven. I
started asking about long term effects
to my ruptured baby. My
perinatologist seemed to believe that
baby “B” would have lungs that would
work fine, but the neonatologist
consult I had wasn’t so sure. I was
scared.
A few days before 31w5d I began having
severe cramping pain and actually felt
strong contractions, but they never
led to anything…however, I could not
sleep on my back any longer, I had to
sleep sitting up. This led to less
than restful nights. On the morning
of 31w 5d I complained of what I
thought was constipation. Apparently
I was in labor, but nobody realized
it. By 4pm I started feeling STRONG
contractions and asked for a fetal
monitor. I didn’t realize I was in
labor. Suddenly, my perinatologist
appeared and did a vaginal exam (for
those that don’t know, once you are
diagnosed with PPROM you no longer
have vaginal exams because it can
introduce bacteria to the region).
The minute he stuck his hand down
there I knew this was it, and I was
immediately saddened – I wanted to get
my babies to 34 weeks. Can you
believe how greedy I became?!
The baby “B”s head had already crowned
so it was a mad rush to get me down to
the OR ASAP. My perinatologist
originally had wanted me to have a c-
section because he wasn’t comfortable
with the safety of a vaginal birth,
but baby “B” was already too far into
the birth canal. They literally
wheeled me into a prepared room, asked
me to push, and in two pushes out
popped my PPROM baby. I listened
desperately for a cry – none. He was
whisked away so quickly I never saw
him. My peri started calling out
desperately for an amniotic hook as he
was surprised to find my cervix
closing up and labor stopping. He
tried one last ditch effort to rupture
the other baby’s amniotic sac but it
was too late. My cervix closed and
labor stopped. Now what? They were
watching the other baby on the u/s.
My peri decided to send me to labor
and delivery and begin pitocin. He
said he would not allow the other baby
to stay inside because of the severe
risk of infection. I was thrilled to
know he was going to let me have both
babies vaginally (my first born was
vaginal) because I really didn’t want
a c-section. But within minutes the
order was cancelled. Baby ‘A’ moved
and it was no longer safe to put him
through a vaginal labor. ARGH! C-
section prep was started. I kept
asking for the status of baby “B” but
no one would give me anything. I grew
worried – I wanted to know if he was
alive. I wondered if they weren’t
telling me because he had died but
they wanted me to have my wits about
me when they worked on getting
baby “A” out. Eventually my
anesthesiologist had pity on me and
went in search of the answer prior to
the c-section. He came back and told
me that my PPROM baby was pink and
intubated. Thank GOD he was still
alive!
Baby “A” was born crying and I was
elated. Then I was whisked away to a
c-section recovery area and given no
information on my babies. I had to
sit there for three hours!! FINALLY
they wheeled me down to the NICU where
I got my first glimpse of my babies.
There were both intubated, but my
PPROM baby was in bad shape. The
neonatologist delicately explained my
PPROM baby’s situation. For whatever
reason I simply smiled and nodded; I
don’t think I fully understood the
gravity of the situation. He couldn’t
breathe, his lungs needed multiple
doses of surfactant, he was on a
special breathing apparatus that did
short quick blasts to help keep his
blood oxygen levels up, and he had
collected fluid along one side of his
lungs that was being drained in an
attempt to help the lung to open up.
Apparently the neonatologist wasn’t
sure my PPROM baby was going to
survive that first 24 hours…but he
came through with flying colors.
Though he stayed intubated for five
days, and did have a meconium plug
that kept him from eating for as many
days, he left the NICU on home oxygen
and nebulizer treatments at six weeks
after his birth – two weeks before his
due date of Oct 14. My other baby
came off of oxygen by day three and
spent the rest of the time learning to
eat; he discharged from the NICU four
weeks after birth.
My PPROM baby was on oxygen at home
for 30 days before he was allowed to
start weaning. After thirty days he
was able to come off of oxygen and he
kept his saturation levels at 98 or
better! He began to grow quickly.
Both are breastfed and have grown very
well. They get the Synagis shot for
RSV every month, and we have
successfully kept them from getting
ill – even with a four year old
brother who attends preschool!
Those that see my 4 mos old PPROM baby
(now a whopping 15lbs – when born was
only 4lbs 2oz) can’t even believe he
was ever preemie, or that he had any
lung issues. He has a cute little
squeaky voice compared to his healthy
brother, but his respiratory
pulminologist says that lungs grow for
seven years and that if I keep my
PPROM baby from getting too many colds
these next two years he has a good
chance of growing up with normal
lungs. I am thrilled!
I don’t know if the following things I
did had an impact on the success of my
pregnancy outcome but here is what I
did.
Drank at least one gallon of water a
day – yes, a real gallon.
Flushed labia region with water after
EVERY bathroom visit (and after
drinking all that water this meant a
lot of squirting)
Took antibiotics for seven days, then
off, then on, then off, then on during
pregnancy
Took my bedrest seriously, but
realized my emotional demeanor was
just as important. At the hospital my
Dr. agreed to one hour/once day
wheelchair rides. On the days my
husband/son would visit they would
wheel me outside to a grassy area
where I could watch my three-year old
son play and take in some warm
sunshine. Sometimes my dog would even
visit me there. It definitely helped
to lift my spirits.
If you have ruptured – take it
seriously – take good care of
yourself. You don’t have a lot of
control, but you do have a few things
you can do to try to help. Be
patient, and keep the faith. HUGS!
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