By Stacey, Illinois USA
PROM at 19 weeks + 3 days. Delivery at 35 weeks + 5 days.
Story added: 2004-08-27

My PPROM story begins like so many others. During the first trimester of my pregnancy I had a significant amount of bleeding. It started when I was 13 weeks 3 days with some small spotting and then waking up the next morning gushing bright red blood. I went that day for an ultrasound and everything appeared normal. The baby’s heartbeat was strong and no signs of a low lying placenta. I was totally freaked out; I thought I had already made it through the scary time (the first 12 weeks). After the gushing, the bleeding slowed to spotting and then stopped for about a week. When it started again, it was not as much but this time and I was losing large clots and having bad cramping. I was so scared I was losing the baby. Again I had an ultrasound at around 15 weeks and everything appeared normal. The baby’s heartbeat was strong and nothing indicated where the bleeding was coming from. Finally, the bleeding stopped and I went on with my pregnancy thinking everything was ok. Boy was I wrong…

On April 11th, at 19 weeks and 3 days I woke up in the middle of the night to some kind of fluid coming out of me. I really thought it was blood and was actually relieved when I got to the bathroom to find out it wasn’t. I just assumed I must have gone to the bathroom and went back to bed. A few hours later I woke up and it happened again so I knew it couldn’t be urine. Right away I knew something was terribly wrong. I pulled out all of my pregnancy books and looked up fluid loss. Nothing really said that your water could break so early in the pregnancy, but I really felt this could be what happened. I called my OBGYN and went into the Labor and Deliver unit of the hospital to be checked out. When I got there they listened to the baby’s heartbeat which sounded fine and did an exam. They tested whatever fluid they could find on a nitrazine strip and it came out negative for amniotic fluid. My doctor said that I must just have had some heavy discharge combined with urine and sent my home. I asked for an ultrasound but she didn’t think there was a medical reason to have one at that time. I felt very stupid and paranoid because of the previous problems I had. Another week went by and I still felt like I was “leaking”. I made an appointment with my doctor’s office and saw a different doctor this time. This doctor also tested with the strip and looked for ferning under the scope but both tests were negative. One thing I remember is that on that particular day I wasn’t leaking very much. She also sent me home and said that everything was fine. I also asked for an ultrasound and this time she said she would order one but that there wasn’t a medical reason and so my insurance probably wouldn’t pay for it. I said fine because I just wanted to know that everything was ok. My ultrasound wasn’t scheduled for about two more weeks and I was still leaking the entire time. At 22 weeks and 5 days I had my ultrasound and it showed nearly no amniotic fluid around the baby. I just couldn’t believe it. I had been trying to convince myself that everything was ok because the doctor said it was. I was admitted into the hospital that day. My doctor told me and my husband all of the scary things that can happen and suggested that we terminate the pregnancy since I’d ruptured so early. There was no way that we could have done that, we wanted the baby so bad. Our other option was to be transferred to a hospital an hour and a half away with a team of perinatologists and a level III Neonatal Intensive Care Unit. I was transferred two days later at 23 weeks. When I arrived, I was met by the perinatologist on duty. She also told me about all of the scary things that can happen including pulmonary hypoplasia but also told me that there are some success stories. They don’t know how but sometimes the baby can survive. Usually there is some kind of permanent disability, especially when you rupture so early. I was checked for any kind of infection, which I didn’t have and started on an antibiotic for ten days as a preventative. They also decided to start me on magnesium sulfate in order to prevent any labor from starting. The scariest thing was that we were told I could go into labor due to an infection at any time. They sent a neonatologist in to talk to us about survival rates at 23 - 27 weeks. My temperature was checked every four hours and the baby was monitored three times a day for an hour as well. I spent 14 long weeks in the antepartum unit at the hospital because thankfully I never did go into labor. We had a few scary days early on where the baby’s heartbeat would dip because of compressing the cord, but that all corrected on its own. I was given an ultrasound once per week for my entire stay for fluid checks and once every two weeks for the baby’s measurements. When I arrived, our baby weight 1 lb and 1 oz and I had no measurable amniotic fluid. Each week I would go to the ultrasound and pray that there was some fluid around the baby. The bed rest definitely helped because within one week I had 8 cm of fluid. I continually lost whatever fluid accumulated throughout the entire pregnancy. I did have a pattern where I would build up fluid for one, two or three days and then it would all come gushing out. It was horrible. Each time I lost the fluid, it reminded me that this baby might not make it. The baby continued to grow fine and my fluid levels fluctuated anywhere from 3 cm to one time having 14 cm. As the pregnancy progressed, I was still told that there would be no way to know if this baby had lungs until she was born. At 33 weeks, they did a measurement on the ultrasound that showed a strong possibility for pulmonary hypoplasia. I was sick for days. It’s so hard to hear any bad news when you have invested all of this time physically and emotionally. Finally, on August 3rd, at 35 weeks and 5 days I was induced. The funny thing was that I had started having mild contractions about 8 minutes apart the very morning of my induction on my own. I was started on Pitocin at 8:30 am and labored for a very long 15 hours. I had an epidural that did not work and had basically no pain control. I really just did not have the strength emotionally or physically to get this baby out. She finally did come out with the help of forceps at 11:07 pm weighing only 4 lb and 10 oz. Once she was out, her cord was cut and she was whisked over to the staff from the NICU to be worked on. The next 20 seconds waiting for a cry were the longest of my life. She did let out a couple of cries (which meant she had some lungs) but then did seem to go into some respiratory distress. The neonatologist came over to me while I was still lying on the delivery bed and said that they were taking her down to the intensive care unit and would put her on a ventilator. She also said that the baby had a 50/50 chance at that time for survival. And then she was gone, I barely got to see my baby.

We found out later that she never needed to be put on the ventilator AND didn’t even need any supplemental oxygen. She was weaned from an Oxyhood to room air very quickly. Finally, about 4 hours after she was born, my husband and I got to go see our daughter. She looked so bruised and had a significant amount of fluid retention. Her head was a little misshapen and I could tell she had some contractures but overall looked pretty good for having been squished inside of me for 4 months. She was put on an antibiotic as a preventative and did have an eye infection that needed to be treated. We saw the neonatologist the day after she was born and she told us that our baby was a miracle and that she was exceeding all of their expectations. We named our daughter Hailey Anne and got to bring her home on August 11th after an 8 day hospital stay.

We’ve had Hailey home for over two weeks and she continues to do very well. Her birth report states that she has small facial features and contracted hips, legs and arms due to the prolonged PPROM and the doctors feel that all of this will correct as she grows. She does have small lungs but they are functioning fine at this time and should eventually grow to the right size.

I thank God everyday for this wonderful blessing. I cannot imagine what I would have done if Hailey hadn’t made it. I spent so many days in the hospital reading the stories on this website and thought it was important for me to post my own story. If you are currently going through PPROM, try not to focus on all of the negatives. Miracles can happen, mine did.

UPDATE MAY 5:th

My daughter was born at 35 weeks and 5 days after a PPROM that occurred at 19 weeks and 3 days. I have found very little information about the babies after they are born, how they turn out, what kind of problems they experience, etc. I thought it would be nice to add an update about my daughter who is now 9 months old. My daughter amazingly never had any respiratory problems at all. Her lungs were put to the test about 6 weeks ago when she had bronchiolitis and she pulled through just fine. Hailey was an extremely colicky baby until she was 6 months old. She was also diagnosed with reflux or GERD at 3 months old. She was very delayed in her gross motor skills up until she was about 8 months old. She was very slow to do everything; she didn't lift her head from tummy until almost 4 months, didn't roll over until 5 months, didn't roll both ways until almost 7 months, showed no signs of sitting until 7 months, etc. She had torticollis (twisted neck) and had to be treated by a physical therapist. The torticollis is now finally gone. I really feel that her muscles were affected by the PPROM since she couldn't move around very much in utero. Now, at 9 months old she seems to be pretty much caught up to her chronological age. She can crawl, sit unsupported, is starting to pull up, etc. She is developmentally fine in other areas too. Her biggest struggle continues to be with reflux. This has caused a lot of pain for her and has some feeding problems as a result. Overall, we are working through these things very slowly.

All in all, Hailey is a regular baby. It has taken me almost this long to get over the fact that she is ok and nothing is wrong with her from the PPROM. I continue to search for answers in hopes that this does not repeat itself with my next pregnancy. Good luck to all of you currently experiencing PPROM. I have to admit it was the most difficult time of my life. But, I made it and so will you.