By Gemma Fennelly, Kildare Ireland
PROM at 18 weeks + 3 days. Delivery at 33 weeks + 1 days.
Story added: 2011-07-19

The day I found this website, was one of the worst days of my life... But it gave me a glimmer of hope, and some much needed informantion! I looked at all the blue stories and the green ones and started trying to make up make up statistics and rationalisations. At first I couldn't bring myself to read the blue ones, and would only read the ones in the week or two around when my partner Gemma's pprom occurred. Like everyone else who comes to this site, I wondered if we going to be one of the lucky ones writing the green story... I don't even know if I would have been able to write this if it hadn't worked out for us, and I have nothing but admiration for the people who have posted their personal stories, because every one shared is a benefit to the people reading them. Anyway, I will try to include as much info as I can remember, I remember wanting to know every little detail.... At 11 weeks, gemma had her first scan, where we saw our little fighter for the first time doing backflips for us (all 4 cm's of him!) and we were in instantly mad about our baby (we chose not to find out the sex). I think its fair to say that we were both nervous, but being a man of facts and figures, I was sure that the odds were in our favour and that all would go smoothly... little did I know!! At approx 16 weeks, Gemma had some dark discharge... so we took a trip into the ER, and a quick scan later, we were assured that all was ok and sent on our way. About a week later, gemma had some pink discharge... feeling a little bit foolish, but still concerned, we again went to the ER, and once again we were sent on our way being told all was fine. Then a few days later (about 17 wks and 5 days)there was some bright red discharge... we thought long ad hard about going in, but again decided it was better to look like early Munchhausen suffers than leave anything up to chance, so we made the trip and for a third time, we were sent home, gemma and baby given a clean bill of health. So, I don't know why I knew that something was different when Gemma called me at 11.40am on June 10th, but as soon as I heard her voice, I knew we were in trouble. She had passed some clear watery fluid while in work (at 18 wks and 3 days), she hadn't been doing anything physically demanding before this happened, it just seemed to come out of the blue - although in hindsight, she remembers having had some mild cramps the night before. We both agreed she should to go to hospital straight away. I was working from home that day, and living about 15km from the hospital (a route I would get to know very well!) I left straight away to meet her there. When I arrived, I found gemma sitting outside the triage office in a packed ER, her jeans soaked through, tears in her eyes. I really thought the worst, but did my best to stay calm. There was a big queue, but when the triage nurse came out, I told her that Gemma's waters had broken and she needed to be seen straight away. Which she was. They ran the fern test which confirmed that it was amniotic fluid, and the scan confirmed that her waters had broken, with little to nothing there (no exact measurement given at that time). The next few hours are a bit of a blur… Gemma was checked into a ward, and some kindly nurse’s gave some words of comfort, but we knew that things were looking grim at that stage. 18 weeks was far too early! When the doctor came around, they gave us the grizzly stats for prom this early, and told us that gemma was most likely going to into labour in the next 72 hours and that nothing could be done for the baby. The next day, still in hospital, we went down for the a detailed scan, we were over the moon when we saw that there was still a heart beat, but disheartened to hear that deepest (and only) pocket that could be found was 0.3cm – we knew little to nothing about this situation, but we knew that was not good. Gemma lost fluid and bled for the next 4 days, but the labour pains never came. She was discharged on Monday, and told that there was about a 95% chance that the baby would either come before viability or be born alive and die shortly afterwards. We were both devastated. Interestingly, on tuesday we received a phone call on the next day telling us that the labs had come back from and earlier trip to the ER... and BV levels of cultures had been found! I know that no link has officially been proven between BV and PROM, but in since there were no other risk factors found, in my mind, this is a major suspect... just my opinion though! Suffice it to say, I was pretty p*ssed off that these results had taken so long to be returned.... is it possible that a timely course of antibiotics might have avoided the whole scenario?? I guess I'll never know. Anyway, the doctor had put Gemma on Klacid LA for a week (and also flagil for the BV), and we (not the doctors) decided that Gemma should instantly go on bedrest, I had been reading every scrap I could find on the internet ever since this had happened and was starting to get a picture of the tough road that lay ahead of us. But at least I knew that there was a glimmer of hope, although none of the doctors had any for us until much later. Gemma went into the hospital twice weekly to monitor for infection, LV swabs, and ultra sounds. The measurements were always low while gemma was on bedrest, and each week we got the same sympathetic looks from the sonographer carrying out the scans, sometime we got figures, other times it was to small to really give an AFI reading, here is the list of figures we were given: Gestation: 18+4 AFI: 0.3cm , 19+4 1 small pocket seen, 20+4 1.55 , 21+4 1.4cm , 22+3 fetal echocardiogram carried out (was scheduled earlier as Gemma has mild mitral valve prolapse) babys heart was fine… cardiologist said she could see a regular shaped chest, i.e.heart wasn’t completely filling the chest cavity, which could be a sign that the lungs weren’t extremely small, but cautioned that they didn’t have technology yet to have detailed look at the lung formation. – But I started to get more hopeful at this stage! 23 +4 AFI was up to 3cm, baby was measured at 1lb 4 oz!! I remember how excited I got about that… although as I’m sure your doctors have told you, the most critical lung development happens from 16 – 24 weeks, this is when you need 3cm+…24+1, crashing back down to earth, no measurable fluid! Gemma has 2 shots of betamethasone at 23+5 and 23+6. We had made it to “Viability” (Anyone else really hate that word?) Gemma’s ob had been nothing but negative from day one, telling us about past cases she had dealt with and telling us that even if by some miracle our baby made it, he would have clubbed limbs, squished facial features and all manner of other problems, but as time went by she very slowly and cautiously started to allow a little hope to creep in, she said that if we made it to 'vialbilty', we should meet a paediatrician to discuss all possible outcomes. We met the paediatrician during week 24, he was the first one that gave us some real hope. He mentioned that there were new treatments such as nitic oxide which were working wonders for babies with underdeveloped lungs, we discussed different ventilation techniques that they had, high frequency oscillators, surfactant, cpap, etc... both our heads were swimming after that meeting, it took a while to process everything, but I really started to feel positive – in hindsight, that was probably premature to be getting so hopeful, because no matter how many advancements they make, if a baby’s lungs are too hypoplastic, there is nothing they can do, and if a baby is right on the edge of life, all these things might just prolong his/her suffering, and maybe they’ll come through it with severe problems for the rest of their life… I remember him saying that given the pprom history and likely lung prematurity from the oligohydramnios, if our child was born at 25 weeks, they would have a 50/50 chance. And every day on top of that increased the chances by 1 – 2%, I liked that! Gemma was checked into hospital at 25 weeks: 25 +2 AFI = 2.6cm, 26 +2 4.4cm!!! I remember stopping reading stories where women had more than 3cm… but remember, most important time to have fluid is 16 -24 and during most of this time Gemma had between 0 – 2cm, but every scan is just a snapshot, so you really have no idea how much or little baby is getting. Gemma drank about 4 – 5 litres of water a day during this time!!! 27 +2 weight 2lbs 4oz AFI 4cm, 28+2 2.7 (28 weeks was always a big target for us after 24) 29+2 6cm!!! 30+2 5.2cm, 31+2 6.8cm, 32+2 3.3cm… Gemma had been getting random aches and pains throughout, and the leaking which was usually clear fluid, seemed to increase in volume as the weeks went by. On friday the 17th of September, Gemma had some pink fluid, which later stopped, but I think we both had a feeling that things were going to happen soon. And four days later, they did! On Tuesday morning (21st of Sept) gemma got a sharp pain and started bleeding, the doctor came and saw her, but they said they would just keep monitoring and see what happened. Throughout the day the blood kept coming, gradually getting heavier, she filled pad after pad during the day, the pads got bigger, and Gemma filled them quicker all the same. Baby seemed happy enough on the trace the whole time. But eventually the blood loss got too much and they decided to take her up for an emergency section. Things moved really quickly after they made that call, she was up in theatre in a matter of minutes while I was told to go into a room and get into scrubs… about 15 mins later, a nurse came and brought me into theatre, at 19:57 our son Caden was born at 5lbs even. We both held our breaths as we waited to see if he had big enough lungs to take his first... After a brief pause he made a little squawk, then a little cry - the best sound in the world! They took him over to the other side of the room where he was mostly quiet, but would make a little reassuring whimper as this cleaned him and did the APGAR's (8/10 at 1 min, 10/10 at 5 mins), they briefly showed him to us then took him away to have a chest xray to check his lungs, and they doctors asked me to leave as they worked on Gemma (her placenta had abrupted, which was causing the bleeding) I went to a room where I waited for the next 20 mins (the longest of my life)… Anyway, I’ve gone on long enough… although I'm sure I've left out a lot! Caden was in ICU for a day and half, about 20hours on CPAP (regular air, 21% o2). He came home after a further 11 days in special care unit, he did have hip dysplasia, which was possibly caused by pprom (but gemma had the same thing as a baby) he had a cast put on to correct that and this treatment has now finished and all looks good. He has no other known side effects from the lack of fluid!! He is gorgeous, full of beans and is spoiled to bits and we feel like the luckiest parents on the world. If anybody would like to contact us for any more details, please do - I did and found it really useful!! paulmurtagh@gmail.com