By NYC Mom, NYC USAI will give the short version here. If you want details, you are welcome to visit my blog. I am giving you the link to the first pPROM posts in March, and then you can read subsequent posts, from pPROM for 5 weeks to the NICU for 6 weeks to the present.
PROM at 26 weeks + 1 days. Delivery at 31 weeks + 1 days.
Story added: 2008-07-09
http://meanmama.wordpre ss.com/2008/03/
This was my second pregnancy. I had twins in Nov of 2005. They were born early but not due to pPROM, just due to being twins. This pregnancy was a singleton, and I was due 6/22/08. On 3/17/08 at 1AM, I got up to go to the bathroom, and once I sat down on the toilet, a steady trickle of fluid started coming out before I'd even released my bladder. Even though my water had not broken with the twins, I knew that that's what was happening, and I could not have been more shocked. I was 26weeks 1 day pregnant.
At the hospital, it was confirmed that the liquid I'd collected in tupperware was indeed amniotic fluid. I was totally panicked. Thought I'd go into labor. Having been treated for symptoms of preterm labor with my twins at 27 weeks (carried them to 34), and having spent a month in the NICU with my twins, I was educated about what having a baby at 26 weeks could mean, and I was terrified. But I had a great team of doctors who kept telling me that others had made it for days and weeks and months without going into labor, and that I had to start thinking positively.
I stayed in the hospital for 5 weeks. I had my temp taken and blood pressure checked many times a day. I got two rounds of steroid shots, two times: once upon arriving at the hospital and once at 28 weeks. I had ultrasounds, including fluid measurements and biophysical fetal profiles, 2-3 times per week. My fluid went up and down A LOT. At one point it was quite low, and then in the last week and a half, it went up. My baby seemed to be doing well. Also, I was on a fetal heart monitor for 30 minutes twice per day. If there were heart decelerations, I was put on it more often. One time I even had to go back down to the labor and delivery floor because of fetal heart decelerations. It resolved, though, and I was sent back up to my room on the antepartum floor.
Doctors would also regularly press on the upper part of my abdomen to see if it was tender, because this would be a sign of an infection. The main fear once your water has broken but you have not gone into labor is, in fact, infection. I did not show symptoms of that.
I kept leaking amniotic fluid. Every day I would leak, sometimes a little and sometimes a LOT. This did not seem to correspond with my changing fluid levels. My fluid was always clear or pale yellow, though I've been told that pink can also be normal. Toward the end (the last 5 days or so), I started to see some blood mixed in with the fluid. We all thought maybe this was a sign, since it was a change for me, and I did go into labor that week.
Since about 21 weeks of pregnancy, I'd had a low, dull crampy, tight feeling. The feeling was never found to mean anything, according to ultrasounds and fFNs I'd had. That feeling started to get more intense in the last days of my pregnancy. I had a night of such painful contractions that I REALLY thought I was in labor. It turned out to be false. A few nights later, I had the same thing, but it did not stop in the morning. My contractions were not picking up on the monitor, however, because they were so low. Finally a nurse figured out how to tie the monitor on so that is was really tight, and the contractions started showing. Upon acknowledging that I was having such frequent contractions, the doctor agreed to do an internal and saw that I was 3 cm dilated.
I was taken down to L&D. I was in a lot of pain, but I really wanted to try VBAC as long as it was safe. The nurses said they'd hold the monitor to me the whole time to make sure my baby was doing well, and my doctor approved. I waited for a bit to have an epidural because I was only 3 cm dilated after 12 hours of labor. However, the contractions started to become so intense that I could not bear it anymore. I got an epidural at 3PM, and when the doctor checked again at 6PM, I was 8 or 9. I pushed at 7, and it only took 20 minutes.
My son was born 31 weeks 1 day, at 4lbs. 5 oz. That is really big for that gestation (babies run big in our family). His apgars were good. We were told by the ped from the NICU that he'd only need a little breath support. However, once in the NICU for a few hours he started having a lot of trouble getting enough oxygen into his blood. The reason for this was never really found. The only conclusion they could draw was that the blood vessels in his lungs would not open, and they treated him for that with nitrix gas. He responded well. This is usually a problem that full-term babies would have, not preemies, so this is unusual and does not point to his lungs being immature.
Over the next week, he went from ventilator to CPAP to high flow nasal canula. A quick transition. In time, he came off the canula. It took longer for him to maintain his own temp and come out of the heated crib. He also started having bradycardia and oxygen desaturation a couple weeks into his stay, and that is what kept him there for the rest of the time (these issues are VERY common preemie issues, but our hospital had a strict policy whereby the baby needs to go 5 days without bradys or desats to be discharged). He came home after 6 weeks in the NICU, without any monitors, etc.
He is now 11 weeks old and doing well. He weighs a chunky 10 lbs and exclusively breastfeeds. His corrected age is 2 weeks (counted from the time of his due date, not his birthday), so he is still not doing all the things that typical 11 weekers do, but on the other hand he does a lot more than a 2 weeks would. He is becoming quite alert and holding his head up. He is a miracle for sure.
We never knew why pPROM happened to us. It is terrifying, as you know. Please know that there is hope. Read my blog if you want, and if you leave me a comment with your email address I will write you back. I can also suggest other preemie blogs. I am happy to hold your hand through this, if you are still struggling.