By Angelika Bernard, Severn, MD USA
PROM at 17 weeks + 2 days. Delivery at 25 weeks + 5 days.
Story added: 2011-11-28

My pregnancy began with an SCH and complete placenta previa that caused nearly constant bleeding from weeks 4 through 15.5. Finally, after trying to be on modified bed rest (with three children) and do as little as possible, the SCH resolved and the bleeding stopped. At 17+2 I had an ultrasound that showed that the SCH had resolved, but that I still had complete previa. That night I was telling my mother that we were going to have a girl and I felt a huge gush of something come out of me. I hung up the phone and rushed to the bathroom. My pad was full of a brownish liquid and didn't seem like any of the bleeds I'd had before. Then my husband suggested that it was amniotic fluid, and I knew he was right. We rushed to the hospital, where the tests for amniotic fluid came back negative and they claimed that there seemed to be plenty of fluid. We went home, confused. The next day I woke up and my pad was again filled with this browish fluid and there was a clear puddle underneath me. We called the hospital and they claimed that it absolutely could not be amniotic fluid because 1. I had complete previa, so there was no way for the fluid to escape and 2. At 17 weeks there could not be that much fluid inside. They said I probably had a bladder infection and was peeing myself. I knew in my heart that they were wrong and proceded to once again be on modified bed rest. At 19 weeks (just past Christmas) I had a check-up with my regular OB and was terrified because I knew that this appointment was the defining moment in my pregnancy. As soon as she began the ultrasound, I knew something was wrong. She left the room and when she came back she told me that she was sending me to the hospital (Johns Hopkins)for a more detailed ultrasound. She then sat down with me and told me that I didn't have to make any decisions that day, that I had already been high risk because of the previa and that this didn't necessarily increase the risk to my life too significantly. In the triage room, they performed the same amniotic fluid tests and another ultrasound. The tests came back negative again and they didn't discuss the ultrasound with me. They admitted me and put me in a hospital bed in a room that was clearly used for storage. My husband and I tried to relax, eat dinner and play some games while we waited. I was going to stay overnight because the ultrasound techs had already left for the day, so the high resolution ultrasound was to be performed the next day. AT 11:30pm, the doctor came in the room and shattered our world. She told us a nicely and sadly as possible that the ultrasound had showed zero fluid around our baby and that this was not compatible with life. She said that we needed to have a D&E performed because the previa made regular delivery impossible. They would still do the ultrasound in the morning, but that we needed to be prepared for the inevitable outcome. They then had a NP from the NICU come over and tell us that babies born before 24 weeks had nearly no chance of survival and that our odds of making it that far were slim. She also said that without amniotic fluid her lungs would not develop and that even if we made it past viability she still would not be able to breathe. However, she also told us that she was do what we planned to do and wait. The next day, they only found 0.5cm of fluid around our baby girl. We still left the hospital, as having a D&E just seemed horrible. My husband immediately called a clinic in Virginia that we had heard about before. They got us in that Monday at 8:45am and were wonderful. The doctors there were still very sad for us and told us that our baby had little chance for survival (about 2%), but that it's really an unknown because so many of these women are pushed to terminate. They said that if I became infected they would do a c-section and respect my little girl. With their observation I made it to 23 weeks and was admitted to the High Risk Pregnancy floor of a wonderful hospital - INOVA Fairfax. I feel blessed to have been near such a wonderful place. They administered the steroid shots immediately. Around 21 weeks I had built up 3-5 cm of fluid, once in the hospital it gushed out completely every day. AT 24+3 I also began gushing blood daily as well. At 25+5 (on Valentine's Day!) the bleeding became too much and they delivered my little girl by classical c-section. Every day on hospital bed rest had been terrifying, but this day is etched into my memory as the worst. I was so scared that she wouldn't live and was crying out to God during the procedure and then... my nurse whispered in my ear "do you hear that? She's crying!" And there it was, the tiniest cry I'd ever heard, but that cry gave me hope, realy hope, for the first time. The NICU team gathered around her, stabilized her and whisked her down to the NICU. She weighed 2lbs 2oz and was 13.25 inches long. She was on the oscillator vent with Nitric Oxide for 6 days and then on CPAP for a month and then on the High Humidity Nasal Canula was another month. She came home with us after 82 days in the NICU, 6lbs and beautiful. She is now 9.5 months old and doing great. Her neonatologists were shocked that we'd been advised to terminate. She was no worse off than any other 25 weeker there, even without fluid for 8.5 weeks. Her NICU stay was full of ups and downs and was difficult, but she is practically perfect now. No surgeries. No oxygen at home. She has only some chronic lung disease from being on Oxygen for her first 2 months. She's our miracle! Where there is life there is hope! I wish that more doctors would read these stories and do more for women who go through pprom. I believe that much more could be done for us to give our babies every chance possible at life. There can be hope. Oh, and we named our baby Joy!