By Deanna, Lumsden Canada
PROM at 21 weeks + 2 days. Delivery at 35 weeks.
Story added: 2004-04-20

This was my fourth pregnancy after three perfectly normal pregnancies and births. The only thing different about this pregnancy was that I became pregnant while taking birth control pill. Everything was going along very well except for a lot of morning sickness that was common in all of my other pregnancies.

At 21w 2d, my membranes ruptured in the evening. I spent four days in the hospital and was put on antibiotics. My husband and I were told at the time that it was highly likely that I would go into labour within 48 hours and because the baby was under 24 weeks it was not considered a viable pregnancy so it was unlikely to survive. I spent the next four days in hospital I worried about every cramp that I thought I could feel. However, labour did not occur and I was sent home on bedrest. I continued to take oral antibiotics for the duration of the pregnancy. I stayed off my feet as much as possible. At 24w I received betamethazone (steroids) in the hospital. I continued to spot blood now and then but nothing significant and no fluid loss. Every week the fluid was at a higher level. It reached a high of 7.3 cm at 25w 6d.

At 26w 1d I started a major bleed and lost lots of fluid. I was taken to the hospital where I started cramping and had pain for about an hour. The physician actually ordered an induction of labour because of the bleeding and pain. As soon as that order was issued, everything stopped completely and labour was not induced. I was put on antibiotics and hospitalized on bedrest for the duration of the pregnancy. I continued to bleed small to moderate amounts everyday and my fluid levels went up and down. The highest it was in the hospital was 5.0 and it went down as low as 1.4 cm. I continued on oral antibiotics in the hospital, had fetal non stress tests daily as well as 2-3 ultrasounds per week. The baby was always fine in spite of all the bleeding and fluid loss. At 30w I had another dose of betamethazone. At 30w 1d I had another major bleed and the fluid went down to 1.9 cm. I began to have contractions that would last awhile then quit. The major bleed slowed down but I continued to bleed throughout in small to moderate amounts. I would occasionally have heavier bleeds and was taken to labour and birthing unit for monitoring. This happened on at least six occasions.

At 31w my obstetrician consulted another obstetrician, more of a specialist in this area, regarding my situation and when to deliver. We were disheartened to read his report in my patient record. He felt the prognosis was “solemn” and that often in this situation the baby’s lungs do not mature. But we refused to believe the worst even though we tried hard to maintain realistic expectations.

At 34w my obstetrician decided to try to obtain a sample of amniotic fluid. Since my membranes were ruptured an amniocentesis was not possible and the sample would have to be collected vaginally by a bedpan. This test was unsuccessful however, because of the gross contamination of every sample with blood.

At 35w, my obstetrician ordered an induction of labour. The decision was based on the low level of fluid (fluid was at its lowest and not replenishing anymore), risk of infection and risk of the continued bleeding.

This labour was the smoothest I had ever had and easiest delivery. Emma Elizabeth was born at exactly 35w gestation and we were delighted that she came out crying. She weighed 5 lbs 5 oz at birth. She did come out a little squished (from lack of fluid). I got to hold her after delivery for a few minutes and then neonatal took her as she turned a little blue. She was intubated for 12 hours. After 12 hours she came off of all respiratory support. She was such a strong little girl that she even ripped out her own nasal oxygen. And she didn’t need it! Her lungs were mature! She spent seven days in the neonatal unit, four of those in intensive care. She had jaundice and spent a few days under the lamps but that is normal for many babies. We worried about everything – as we had been advised all along in the pregnancy of all the things that could go wrong. We worried about vision, hearing, infection, limb compression and everything else. One by one all of our fears were dismissed as she was tested for infection and given ultrasounds on her hips, cranial and kidneys and all came back normal. She was breathing well and her lungs were normal! Her feet were a little twisted and her legs didn’t seem to straighten very well. All of this straightened out in the weeks that followed and she has no problems now.

When we brought her home she weighed 5 lbs. (at one week old). At ten weeks, she weighed over 10 lbs.

Emma is a beautiful baby and aside from her difficult gestational period, she is no different from any of our other children. At three months old she gains weight at a healthy rate, feeds well, smiles and coos at us, sees well, hears well and sleeps well.

We know that Emma is a gift and that it is not normal to have PROM for 14 weeks.

All along every nurse and doctor told us that this is not the norm. I continued to defy the odds right up to the end. I never had infection and was always able to retain some fluid, especially around the baby. I never went into labour by myself so I’m not sure how much longer the pregnancy would have gone on if I had not been induced into labour.

I want to post my story here because I know how hard it is to go through this situation and how important it is to have hope. Doctors will not always tell you everything and sometimes don’t tell you that it is perfectly possible for the pregnancy to continue and the baby to be fine. Perhaps they don’t want to promise anything and want you to maintain realistic expectations. I found a lot of peace in knowing that other women have been through this and their babies were fine.

I never once believed that I would lose my baby in spite of the odds of it happening. We did, however, understand that whatever was going to happen would happen and there wasn't much we could do about it except have faith.

There are four pieces of advice I would give to anyone in the same situation: never be discouraged by what doctors say (they have been wrong); have patience while you are on bedrest (everyday really is one day better for the baby);
it IS possible for your baby to continue to develop and be born perfectly healthy after PROM and, most importantly, always have faith, miracles do happen!