By Carolyn Garisto, Harrisburg, PA USASaturday, June 14, 1997 at 2:45 pm, I was 24 weeks, 1 day pregnant with my first & only child when I felt quite a bit of wetness. I foolishly thought the baby had shifted onto my bladder, causing me to leak a little urine. It continued for 24 hours & stopped abruptly. The entire time the baby moved & kicked. Three days later I started to leak again & called my OB. I went to the hospital for an ultrasound & the tech reported her findings to the OB over the phone. He ok'd me & sent me home. During the drive home, the ultrasound results were delivered to the OB.
PROM at 24 weeks + 1 days. Delivery at 31 weeks + 3 days.
Story added: 1998-12-11
When I walked in the door, the phone was ringing. My OB suggested very calmly, I might add that I return to his office to meet with a perinatolagist & could I bring my husband- But, really, there is no cause for alarm. The perinatolagist performed another ultrasound & confirmed that my water broke. After an hour long fetal monitor, they also confirmed that I was having contractions that I couldn't feel, but were indeed the start of labor. I was admitted into the hospital onto the labor & delivery floor, because noone could guarantee me that I would not deliver a preemie that night. They started an IV of antibiotics to ward off infection and Magnesium Sulfate to stop contractions. I was devastated & could barely comprehend the situation because less than 4 hours ago, my baby was fine! They told me so!
In came the barrage of neonatolagists to explain that my baby had a 63% chance of survival, the lungs were very immature & it would need a ventilator. I was given a shot of betamethisone to boost lung development and told to rest. I was hooked up to a constant fetal monitor which I couldn't understand. The heartbeat sound it made got on my nerves after 5 minutes. Let me say that I had no comprehension at that point what a life line that sound would be. A lamaze teacher came in to give me a crash course in pain management & I basically laughed at her. I wasn't delivering, I am scheduled to start my classes next week! I tried to get some rest, but all I heard that night were screams of pain & cries of pleasure from all the mothers delivering their beautiful, healthy babies like I was supposed to in another 16 weeks.
The next morning another peinatolagist the 2nd in a group of 2 came in to see me and confirmed again, that "Yep, your water broke. Man, there's hardly any there!" Thank you very much, idiot! I actually became very close to this man & learned to adjust to his way of doctoring. They confirmed that they had slowed down the contractions, but wanted to keep me in L & D for constant monitoring. I received a 2nd shot of betamethisone. I thought I would go crazy, because I felt normal but I wasn't allowed to shower & had to call a nurse every time I had to pee so she could chart how much! After two days, the drs. agreed that I was stable enough to be moved to the Woman Care floor designed for female patients of all types & some of the nurses were trained for preterm labor .
I was thinking I would be discharged & watched very closely, but I learned that PROM has a very high risk of infection for the baby. The first day on this floor, I was told by a nurse that "You moms that aren't sick can do your own tracking of fluid intake & output, don't call us to dump your hat." the bucket to collect fluid, if you catch my drift I was OUTRAGED. Here I was, told that I couldn't get out of bed, let alone go home to get anything & that I had to STAY until I delivered whenever that may be and some dumb nurse is saying I"m not sick--- I lost it. I continued the IV meds & weekly betamethisone shots and they gave me a mini-pump to administer Terbutiline to also help with the break through contractions I was having. The nurses checked my temp & blood pressure every 4 hours.
The drs explained that the goal was to make it to 32 weeks, & then we would discuss shutting off meds & seeing what happens. I had daily Biophyscial profiles indepth ultrasounds to monitor fetal development & 2 fetal monitor strips were run daily. I became very adept at interpreting the profiles & strips. My first strip was run at 7am & I would wake up for the positioning of the conductors, then just lay there and listen to my baby's steady little heart beat & just pray that we would be ok. My days were long & boring and I sometimes felt a little stir crazy.
My husband was a saint, because on top of all this, we had just moved back to the area & he was trying to adjust to a new position at work. And, we had been looking for a house while living in a service apartment. My husband was wonderful about that. He would go out on Saturday morning house hunting & come in with the camcorder to show me the latest prospects. The Drs approved a 15 minute wheel chair ride daily, but even that became kind of a pain in the butt. I had to ask whoever was visiting if they wanted to go get a drink, never letting on that this was my break for freedom!
After about four weeks, I lost it. I completely broke down & cried and yelled & begged them to let me go home. Looking back on this I am appalled, because I was asking them to disregard my baby's health & just let me go. I actually tried to bargain with the Drs about the shut off date for my meds. I remember saying that maybe 30 weeks would be better, maybe 31, PLEASE- That one week makes all the difference in the world for a preemie, but at that point I couldn't see that. I can remember crying & telling them, "I would give anything to just walk away from this for even 5 minutes. Just act like this wasn't happening."
That outburst put things back into perspective a little and gave me the resolve I needed to hang on. Meanwhile, medically, my arms were starting to rival a seasoned drug users, so they decided to install a PICC line partially inserted central catheter so they wouldn"t have to change IV sites every 5 days. This was inserted too far & it actually went into the heart chamber. It set off a little PVC that sent my heart beating madly every once in a while. It was fixed, but I was moved up to the cardio floor for 24 hour monitoring. I felt like a zoo creature because these nurses wanted to know everything about preterm & what was that little terbutaline pump I had & how did it work- My ekg read normal so back downstairs I went to my old room, which they held for me. It was cute, the nurses put up a little Welcome Back sign & all stopped by to say hi.
A few days later about 5 weeks into this it started. I went to the bathroom one afternoon & there was blood. I panicked & the drs came to check it out. My cervix was still closed, so they ran blood tests. They confirmed that my placenta abrupted, but not enough to cause harm. The bleeding stopped & the baby continued to kick & show great signs on the Biophys. It even learned to roll & kick my ribs! I want to point out, that NEVER during the daily ultrasounds did we find out the sex. After all this happening, I wanted one surprise left. We named the baby Roo after Kanga & Roo.
Days moved by pretty uneventfully until my placenta abrupted the 2nd time, August 1, 1997. They moved me back down to Labor & Delivery for continuous monitoring because the contractions were pretty strong. I could feel them & they were registering pretty well on my strips. I remember thinking, this is my father-in-laws's birthday today, please let me hold off until tomorrow. This baby will never live it down. I stayed over night down on L&D & again. Pain & screams filled the air. This time I was terrified. The contractions settled down & back upstairs I went.
August 4th, 31 weeks 3 days, I woke up not feeling quite right. I immediately told the nurses who called the Dr. I skipped breakfast on advice from the dr, and ran the strip. Sure enough, I was contracting at regular intervals, but no bleeding this time. I called my husband & told him that I was being moved downstairs to L&D a normal procedure at this point, and I think there was something in my voice that said this is it. He left work & came to spend the day waiting.
At 2:30pm I told them that I thought I abrupted again & just hadn"t bled out yet my medical diagnosis. The nurse joked that maybe I should go to school for this. The blood results came back & I was right. We all talked about it & the Drs thought that we were close enough to 32 weeks & I had 7 shots of betamethisone under my belt. The baby looked good on that morning's biophys. I panicked & begged them to wait a little while longer. What a switch. Three weeks before I was begging to quit, now I was begging them to stop the contractions & let me continue! They won in the end and let me turn off the IV.
By 4:30, my contractions hadn"t changed & they decided to help things along with Pitocin. It did nothing but make my contractions very strong. My husband went to get a bite to eat around 6:30 and I laid there crying. My mom kept calling wanting to come over & I told her no. I wanted to be alone with my husband & I would call her later. After 10 hours of Pitocin, and no dialation, the Dr. tried to manually dialate me. I thought I was going to pass out from the pain. I begged for an epidural. 4:00am, the anasthesiaoligist came in to administer the epidural. My husband left the room & they started it. Finally some relief. My husband came back in & we waited for the epidural to take full effect. So I laid there listening to the heartbeat & loving the relief I felt.
Then the baby's heartrate just started slowing down. It was like slow motion. All the way down to 60 bpm. They gave me an oxygyn mask & called the Dr. We discussed very quickly the cesarean procedure & he left to scrub up. I was given a huge dose of Phenabarbitol which had me in left field because, for some reason unknown to the drs, it helps reduce brain bleeds in preemies.
The phone rings in my room. I fully believe that mothers have an internal monitor for their children because it was my mother. She had woken up 10 minutes before with this intense fear & couldn't put it out of her mind. I told her what was happening & she said she would be right there. They wheeled me into the delivery room & asked my husband to wait a minute until they were set up. The Dr started to cut & I could feel it. I yelled & he told me they couldn"t wait, that they were putting me under. The last thing I remember was asking for my husband. From my husband, I learned that the nurse went to get him. When they were walking back to the OR at 4:46am, he heard a cry. The nurse turned & said "that"s your baby." He was amazed because the baby wasn"t supposed to be breathing the Dr's told us. It was going to be small & weak & sick! I found out later that when Nicholas came into the world & screamed, the whole OR just kind of froze. They were standing by with a ventilator because he was only 31 weeks 4 days. His apgars were 9 & 9 and he weighed 4 lb. 3.6 oz. and was 17-3/4 in. long. Fifteen minutes later I woke up to see the Dr standing over me. The first thing I asked was "What did I have?" The second thing was "Is he ok?"
"Room Air" sounded like the best words ever uttered. My baby was breathing fine. No vent or extra oxygyn needed. The Dr was kind enough to take a picture of my handsome, BREATHING, little boy. Nick spent 24 days in the NICU with no problems at all. He was simply a feeder/grower, as the nurses called it.
Sixteen months later I sit typing this & wonder what happened. My son is the happiest, healthiest 31.4 weeker I have heard of. He has no residual problems & has been caught up developmentally for months. He even has all of his teeth with the exception of two-year molars. My husband & I are still very frightened about the idea of this happening again. I long to have another child, but my Drs can offer no explanation or odds on repeating this.