By Jennifer Holler, Kyle, TX USA
PROM at 23 weeks + 1 days. Delivery at 34 weeks.
Story added: 2011-11-27

I was highrisk when I first became pregnant due to Type 1 Diabetes. I was seeing an endocrinologist every 2 weeks and was monitoring my bloodsugars from when I first found out I was pregnant. I was 2 weeks pregnant when I found out I was carrying a baby. So almost from the time I first became pregnant I was seeing a high-risk gynocologist. All of my appointments went well with my doctors. My baby was looking great and growing and we had no signs of problems. My sugars were a little harder to keep under control in the mornings but I was put on an insulin pump at 4 months to help tighten my bloodsugars to decrease any complications. My pPROM story all started on a Thursday morning. I was 23 weeks that day. I was getting ready for work and I let out a sneeze. I remember being in the guest bathroom and I thought I had peed myself. So I thought nothing of the incident and went to work hoping I wouldn't keep peeing myself. Nothing happened for the rest of the day and I went home to look up tickets for a concert that my husband and his friends wanted to go to. Last minute we got tickets and met up with them at around 7ish. I remember being really upset because it was an outside concert and everyone was smoking! We were at the highest point and I remember trying to keep away from the smoke but we just couldn't escape it. At around 9ish I remember getting extremely hungry and went to grab a hot dog. I finished eating that and I felt some 'trickling'. I can only explain it as the feeling of my period had started. I thought I was having a miscarriage and went to the outhouses to make sure I wasn't bleeding. I checked and I wasn't bleeding but there was a lot of leakage, no smell and it seemed clear from what I saw on my undies. I kept it to myself but started getting antsy and told my husband I wanted to eat and go home. It was past 11 by this point and I needed to eat, drop his friend off at home and get home so I could wake up for work the next day (although I was considering calling in since it was so late). We stopped at IHOP and I rant to the bathroom again, something just didn't feel right. Again the fluid was clear with a few whitish chunks and trickling periodically. I texted my mom asking her "what should I do if I'm leaking tissue?". She said that if I'm worried about it to call my doctor, I said I'd call back in the morning if it got worse. I showed the text to my husband then started doing research. Alot of stuff said I had leukorrhea(slimy discharge common in pregnancies - aka "the snail trail"). I felt better about it and drove home to get ready for bed. It was past 1:30 when we climbed into bed and I felt very 'off'. I kept waking up to trickled. Finally at around 4 am I had a huge gush. I screamed and jumped out of bed saying that my water had broke. I ran across the bedroom into the bathroom to turn on the light. I had puddles of fluid in the bathroom. I called my doctor and she instructed me to come in right away. I peed, changed and we were on our way. We drove 45 minutes to the hospital and they rushed us to L&D right away. I hadn't leaked since I peed. They did a speculum exam and the doctor did a test on the fluid to see if it was amniotic fluid. She even did an ultrasound. All came up showing that our son had plenty of fluid and I had plenty of fluid. My doctor even joked "Well! At least you don't have ruptured membranes! That would be awful." I remember sitting there being like "WTF are membranes?!" <-- Shows you how clueless I was at pregnancy! I was sent home told that I had peed myself but if it continued to happen that I should call my doctor again and they'd squeeze an appointment in for me at her office. We drove home and climbed into bed. My husband had a late work shift so he was going to nap and I was told to take the weekend easy. I tricked about 2 hours after I got home and called my doctor again. I didn't receive a call back so after 45 minutes I called again, my call was promptly returned. This time it was a male doctor who told me to just come back again and they'd do more tests. Against my husband's wishes I drove the 45 minutes again. I had my mom and friend meet up with me at the hospital. They walked up to L&D with me again and I joked with the nurse who had discharged me earlier that I promised I wasn't overreacting. They had me change into a gown so they could do another speculum exam and my mom and friend waited outside. As soon as the nurses pried my legs open I had a huge gush of fluid leak all over them. From the looks on their faces I knew something wasn't right. I remember the older nurse looking as though her heart had sank and the younger nurse held her composure. The said some words to each other along the lines of "Yes, that's amniotic fluid. Call the doctor" and stopped messing with me to go inform the doctor. I burst into tears at that point but I still had no idea what they were talking about (we did SOME research, but I had no idea the extent of what we were about to go through). My mom and friend came back in and I told them to call my husband right away. They waited until Steve was there and my parents, in-laws and friend were still there. They had already hooked me up to IV's and a catheter. They started mag drops and steroids soon after. They had to get permission from my diabetes doctor before injecting the steroids since it would effect my bloodsugars. I remember the neonatologist coming in but not a lot of what he said. I was trying not to cry but it was hard because I kept making eye contact with my dad who was crying. He told us that rupturing at 23 weeks gives us no chance of survival and that during 23 weeks I have the chance to terminate. We could either deliver my son or terminate him. If we decided to deliver that we could either not have any help from the hospital and make him as comfortable as we could until he passed OR we could instruct the hospital to do everything they could to keep him alive. We chose that if I did go into labor that we'd do everything we could to keep him alive. I was told that after rupturing most people go into labor within 48 hours. If they don't, they usually go 2 weeks and then deliver. He told us the statistics that if I went into labor at 23 weeks that our son had a 5% chance of a healthy survival, the rest was either morbidity rates or filled with severe mental retardation, brain hemorrhaging, poor lung development, speech problems, appendage disabilities, cerebral palsy, etc. We even had a Catholic clergy member come in and do a few prayers with us (we were at a Catholic hospital). I guess they gave me the mag shots during this time because I felt extremely sick and confused and tired. My dad slept in my room that night, my husband had to leave to go back to work the next day. I was finally able to shower that Sunday. I feel gross, I hadn't showered since Wed. night. I'm so unbelievably lucky that I didn't get an infection. I would have taken one the night I ruptured but we got home so late! That was the best feeling shower of my life and I finally had the catheter out. They moved me out of L&D that night and over to antepartum. I had to shower sitting down and it was limited to reduce gravity and leakage. The day I ruptured I had an ultrasound of 10cm of fluid. I was told I probably ruptured due to an infection setting in and this was my body's way of fighting it off. My doctor seemed happy with my fluid level until the following week when it measured 1.1cm. She then instructed me that I had to lie as flat as possible for as long as possible. I only sat up to eat, to use the bathroom and shower. I had a few scares. At around 25-26 weeks I went to the bathroom with a bright red color to it. I was rushed back to L&D and they did another speculum exam. I was hooked up to monitors to make sure I wasn't having contractions. They thought maybe my son had kicked my cervix and caused it to aggravate and bleed. They were making sure the placenta wasn't tearing either. We had a few more scares of bleeding and contractions. I had one night, at around 28 weeks, with contractions throughout the night 2 minutes apart. I didn't feel them but they showed up on the monitor. I had my 2nd round of steroids at 24ish weeks and mag about 3 times. At the orders of my doctor we sheduled my c-section at 34 weeks. She actually scheduled my surgery over a month in advance because she thought I'd make it that far. She didn't want me going any further since the risks of delivering at 34 weeks outweighed the drawbacks. Jackson came out screaming Dec. 9th, 2010. He weighed 4lb, 1oz and was 17in. long. He was on the cpap for 5 days and on and off a breathing cannula for about 40 days. He was able to regulate his temperature after a few weeks but not his oxygen saturation. He had a pneumothorax and heart murmur (PDA) at birth. Both of those corrected themselves after about a week. He had anemia and that's why he needed the blood transfusion. His color instantly changed after he had that done. He was in the NICU for 47 days and came home 5 days after his original due date. They were discussing sending him home on oxygen but a few days before he came home he decided that he no longer needed oxygen. He's almost a year old and he's over 22 lb. He's almost walking and he has 5 teeth. He has some breathing issues which are treated with nebulizer treatments. He's had RSV twice, salmonella (thanks to my brother and his germies lol), and various stomach bugs which are all passed on to me. He's the happiest baby in the world though and I feel so blessed. I wish all of you mom's going through this right now the best of luck.