By Rachel, Pennington, NJ USAMy story starts out very similarly to most of the posts on this site. This was my first pregnancy. My husband and I were married 8 years when we decided we wanted to start a family. Both of us had been focused on furthering our education and our careers until that point. Fortunately, I got pregnant fairly quickly. The early part of my pregnancy had been easy…without typical mood swings, morning sickness, and food aversions that I had heard about from many of my friends. Even my weight gain had been on target. Most of my friends joked that they didn’t believe that I was pregnant as at 5 months pregnant, I had gained only 9 pounds. That all changed abruptly when I woke up one night with the feeling of wetness in my bed. At first I thought I had wet the bed. Then I realized that there was no smell of urine. When I got up to go to the bathroom, I noticed additional clear fluid was leaking out of me. By that time, my husband woke up . When I told him what was wrong, he immediately reached for the "What to Expect When You Are Expecting" book which had been on the nightstand. He read about Premature Rupture of Membranes and realized that we should call our doctor. The doctor told us to go to the emergency room and he would meet us there. We rushed to the emergency room.
PROM at 25 weeks + 5 days. Delivery at 34 weeks + 2 days.
Story added: 2007-04-23
At the emergency room, they tested the fluid and performed an ultrasound. The doctor confirmed that my water had broke. Since my local hospital did not have a NICU, they called an ambulance to bring me to the Robert Wood Johnson University Hospital (RWJ ), which is about an hour from my home, as RWJ is equipped to deal with high risk pregnancies and premature babies. They also started me on IV fluids and gave me steroid shot to help the baby’s lungs develop should he be delivered. From what the doctor told me at my local hospital, I thought it was inevitable that I would go into labor within 48 hours. I started panicking as I knew that at 25 weeks and 5 days, the baby was very small and there were certainly risks associated with delivering so early.
When I arrived at RWJ, they gave me another ultrasound, performed a pelvic exam, and tested the fluid. They confirmed that I experienced PPROM. However, this doctor told me that while there is good chance that I would go into labor within 48 hours, it was possible that I would continue to carry the baby for weeks or possibly even to term and I would remain in the hospital until I delivered. The first 3 days at RWJ, I spent in the Labor and Delivery unit. I was on a fetal heart rate and contraction monitor 24 hours a day. They started me on 2 different antibiotics as I was informed that due to the rupture and lack of amniotic fluid, I was a greater risk of infection. I was also warned that if I showed any sign of infection or labor, they would deliver right away. Since my baby was breech, I would have an emergency C-section.
After 3 days, they decided to move me to the Antepartum ward, where I would stay until I delivered. They would deliver me at 34 weeks even if I did not go into labor as at that point, the baby would be at a good point developmentally and the risk of infection for me would increase. I was very relieved to move out of the Labor and Delivery ward as the bed was super firm as they are designed for pushing. Additionally, I was stuck using a bedpan while in L&D. I was told that when I moved to the Antepartum, I would likely be allowed to get up only to go to the bathroom. Lastly and most importantly, it meant that the doctors did not think I was going to go into labor any time soon.
I spent the next 8 weeks in the Antepartum ward on bedrest. I was allowed to get up only to go to the bathroom and shower. I continued leaking fluid and each ultrasound showed that my fluid level remained extremely low. My monitoring sessions (now twice a day for an hour each) were stressful as a result of dips or decelerations in my baby’s heart rate. These dips were likely caused by the baby cinching the cord as a result of the lack of fluid. Luckily the dips did not last very long, the baby always reacted, and his heart rate would return to normal. My doctors said that dips are quite normal for PPROM patients. Regardless every time it happened, my stress level increased. Every ultrasound showed that the baby was growing and doing okay in his cramped environment. I continued to get regular ultrasounds and my temperature and blood pressure were closely monitored. Against all odds, my body and the baby continued to cooperate. I made it beyond several milestones – 28 weeks, 30 weeks, 32 weeks. During those 8 weeks, I was lucky enough to have amazing support from my husband, family, friends, and colleagues. I don’t know that I could have made it without them.
My c-section was scheduled for March 21, 2007. And I made it!!! Jacob Aidan was born at 12:01 PM on March 21, 2007 (34 weeks plus 2 days). He weighed 4 pounds 11 ounces. He cried when they were cleaning him off. My husband followed him to the NICU for his initial assessments. Dad reported back to me as soon as he could…that was the longest hour of my life. Jacob was doing fine. His apgar scores were 8/9. He was put on CPAP to assist with his breathing as soon as he arrived in the NICU. Other than the CPAP, he was given antibiotics as a preventive treatment of possible infections. By the end of the first evening he was taken off of the CPAP and put on a nasal canula. Everything else looked good. All blood work showed no sign of infection. Jacob started feeding from a bottle within 2 days. While he was eating a very limited amount of food at first, he seemed to have the suck swallow reflex down. He did need to go under the bili light as a result of slight jaundice by day three but this was something we expected. Jacob continued to feed more and more each day. All the doctors were amazed how well Jacob was doing considering his less than ideal living conditions in utero. By day 8, he was moved to the Special Care Nursery and was released late in the day. Jacob has been home for 4 weeks and continues to do very well. What a journey! I hope anyone who is reading this from their hospital bed can find some comfort in my story. While it is all very scary, positive outcomes are possible. Think positively. I truly believe in the power of positive thought and Jacob is proof of that.