By Kelly McClure, Cincinnati, Ohio USAMy story begins like many of the other stories I've read on this site, 1st trimester bleeding and even the passage of some tissue. That was at 12 weeks. After an ultrasound was performed and our baby looked great we were reassured that everything was fine. Not so.
PROM at 18 weeks + 1 days. Delivery at 25 weeks + 1 days.
Story added: 2001-08-05
On April 27th, I was 18.1 weeks along. Feeling great, feeling the baby really starting to move everywhere. Three times during the day I felt like I had leaked fluid. Oh, I should mention that I am a Labor and Delivery nurse. Went to get checked out by my Dr. and everything looked good. We found out we were having another son, Mason would be his name, and he was swimming in fluid. I guess I was crazy.
Went on to work, still felt like I was leaking, but then it happened a huge gush of fluid that was running down my leg. That was on a Friday. After spending the weekend in the hospital on bedrest, antibiotics, IV fluids, by Monday my fluid was zero. Seeing our son go from swimming to squashed was gut wrenching to see.
We had two consultations from 2 different perinatologists that weekend, one of whom I knew from my job. Neither had good news: <5% chance of re-sealing, about a 90% chance of getting an infection, about a 90% chance of miscarrying within 2 weeks, about a 20% chance of survival if we made it to viability, joint contactures, smooshed facial features, and of course the biggest concern hypoplastic lungs. Although we were never advised to induce we kind of felt like that was the message we were getting from everybody. But I got the best peice of advice from my midwife, "when you don't know what to do don't do anything at all"
So we left the hospital not knowing what to do and pregnant and just hoping that whatever was supposed to happen would happen. I prayed and prayed sometimes not even knowing what to pray for and then Tuesday night, 5 days after my water broke it came to me so clear at 3am. My baby was moving like crazy and I really hadn't felt much movement since water broke. Laying there, awake and crying, I felt a strong urge to go into my 2 year old sons bedroom. I looked at him, so beautiful and innocent, would do anything to protect him from harm, and I thought "I have another son and I have to protect him."
So I continued on being pregnant, hoping for a miracle, but still leaking fluid. When I was 20 weeks pregnant I heard about a Perinatologist in Lexington,Ky that was performing an investigational procedure to try to create a seal to prevent fluid leaking out. I got in contact with him and had a consultation and found that I was a candidate for the procedure(The AFI had to be less than 2, again mine was zero) The procedure consisted of a cerclage, injecting gel foam into the uterus with the goal being for it to settle in the bottom of the wound near the cervix to prevent leakage, and performing an amnioinfusion. We thought our prayers had been answered. Unfortunately, it didn't seem it was going to be successful for me. When I got out of surgery I started having horrible contractions and ended up on the very nasty drug to stop labor, Mag Sulfate. Five days later I left the hospital with very little gel foam left inside, an AFI of 2, and miracously still pregnant. I continued on oral medication to stop contractions and antibiotics and of course bedrest and plenty of fluids.
Everything was kind of status quo for the next 2 weeks then at 22 weeks I started bleeding. I was devasted to find out that the bleeding was from the placenta. I thought how much more can this little guy take.
At 23 weeks we went back to Lexington and my AFI was 0.8cm so we had another amnioinfusion perfomed. After 5 shots of Brethine and an AFI of 4, we headed back to Cincinnati.
At 24 weeks the bleeding starts again and my OB decides its time to turn me over to the high risk docs for good. I was admitted to a level 3 hospital for the duration. I was no longer in control and things just went down hill from there. Scare of infection, contractions, mag sulfate, bleeding. But after a week of being there things seemed to be getting better. My temps were normal, my contractions were under control with mag, brethine, and procardia, the bleeding was less, and Mason was moving a lot. I was 25 weeks and felt like I would be pregnant for several more, I was having a good day so I thought. Around 4:00 I felt a lot of bleeding, called the nurse, and thank god she thought to check Mason's heartbeat and it was 70 (half of what it should be)doctors and nurses came running and the next thing I knew I was being rushed to the operating room. I awoke a little over 2 hours later in recovery room with my family there and was told that 50% of my placenta had tore away(placenta abruption) and I had a very sick 1lb 12oz son. He was in very bad shape at birth, his lungs were so bad it took ten minutes to be able to properly get oxygen to them and his heartrate at birth was 20 and it took four doses of epinephrine to get his heart going. My husband and family were told Mason wouldn't make it through the night.
Mason is now 7 weeks old and although progress has been slow its better than no progress at all. He was a special ventilator called an oscillator for a week, then he went on CPAP which provides a constant amount of airway pressure to keep the small sacs in his lungs open but he does all the breathing on his own. He has terrible reflux and has to be tube fed into his intestines, but he's up to 2lbs 5oz. He does have contractures in his arms and legs that he gets physical therapy on. He is absolutely beautiful and so sweet. We of course don't know the long term outcomes yet. He does have lung disease which he'll outgrow and there has already been some discussion about cerebral palsy but it doesn't even matter. What matters is that he is here. His existence can only be explained as a miracle.
Having gone through this I want to offer some advice to those struggling now with PROM: Don't make any decisions until you are out of the hospital, speak to a perinatologists and more importantly a Neonatolgist(they were the only ones that gave me any hope), insist on staying on antibiotics, find a perinatologists that will do amnioinfusions(even though you risk labor, I'm convinced that my son's lungs are functioning because of having fluid on 2 occasions for short periods of time), insist on admission to the hospital when you reach 24 weeks, learn about placenta abruption it's very common in PROM, and read and re-read the survival stories on this site(it gives hope that you to will have a baby) If any of you reading my story would like to contact me by email please do.