By Anna, Perth Australia
PROM at 25 weeks + 5 days. Delivery at 38 weeks + 4 days.
Story added: 2008-12-19

Hello. Please hold HOPE and COURAGE that each and every day you continue with your pregnancy you are nurturing your little one with your love and protection. Even one more day makes a difference. I never let that thought go! I grasped it with both hands and held ever so tightly. My little miracle is now a smiling and cooing 8 month old who is dribbling and chewing a toy whilst she crawls around my chair. This is my story......

My one and only PROM occurred in an otherwise healthy and robust 4th pregnancy, despite having long term but tightly controlled Diabetes treated with insulin. My first three children are young adults (aged 18,21 and 24) and mercifully not placing strenuous physical demands on me any more.

One week prior to the PROM I ate one spoonful of a take away coleslaw from KFC before noticing that there was a brown coloured sludge like substance in the rest of the container. I threw it immediately in the rubbish and although shuddered with the thought of a possible bout of food poisoning thought little more of my indiscretion of eating out of home during pregnancy. I had broken my own commandment!

Within 3 hours, upon bedtime, I had a 38.3 degree temperature, strong cramps in my lower abdomen, B.P. of 60/40, Pulse of 130 bpm, was trembling and feeling faint. Presenting at the A&E for monitoring myself and baby had a reassuring effect and within 3 days of being admitted I was seemingly healthy and strong once more with no ill effects to the baby. I took no medication at this time. Despite multiple swabs being taken for cultures no pathogen was discovered. An ultrasound showed a healthy baby and AFI of 20 cubic cm.

Exactly 7 days later, also at bedtime I felt a little trickle of fluid between my legs and upon getting up to the bathroom gushes of amniotic fluid began running down my legs.

Another admission to the A&E was necessary. By this time I had gone into labour. I was terrified and could not believe that after 3 uneventful pregnancies this time around was so different and now fraught with an unexpected outcome. Over the course of 12 hours I continued to contract and loose gushes of amniotic fluid whilst lying slightly inverted on a delivery table and attached to a Fetal Heart Monitor. An ultrasound revealed a healthy baby, but my AFI was now just 3 cubic cm. My swab for lacto-placental hormone was positive and according to staff meant definite delivery within 24 hours or at the latest 7 days post rupture. I agreed to a course of steroids to help protect baby's little lungs if born. This involved two Celestone injections 24 hours apart.

Miraculously after this 12 hour time frame the contractions just plain STOPPED as quickly as they started. I didn't allow any VE's to be done to check for dilation but the visual exam with the speculum revealed none-1cm of movement of my cervix. I was to remain in the labour ward for a further 36 hours before being transferred to the ante-natal ward. I was informed that this is where I was to stay for the duration of my pregnancy as I was to deliver a highly prem baby who would be ELBW.

I stayed hospitalised for 1 night and then made the decision to return home to a sterile, quiet, less stressed, familiar and restful environment. I agreed to 4/24hr obs of myself and baby. also a WCC and CRP twice weekly on myself to monitor for a chorioamnionitis. I also consented to a well being ultrasound once a week to monitor AFI and growth.

Then we began the long haul. I was living with an hour by hour proposition of the very early birth of my baby and all that involved. My partner and I decided that he would take leave from work effective immediately and we just battened down the hatches at home. No visitors except for our private midwife (I had booked a home birth) and my three eldest now living out of home adult children.

My partner cooked 3 nourishing meals a day, helped alleviate my boredom over what fluids to drink to make up the 3 1/2-4 litres I set myself as a goal. I knew that the placenta would continue to be nourished and hydrated if I was and that was the lifeline for the baby. I developed a strong craving for fresh passionfruit at this time and allowed myself to satisfy this by eating up to 12 per day. I think the vitamin C was probably helpful and they were full of juice too which was ideal. I added 2 probiotic capsules into my diet each evening. I added 6 fish oil capsules as well per day. I tried to avoid caffeine and too much sugary/ trans fat type food to help prevent Candida getting a hold.

I used personal wipes after each visit to the bathroom. I avoided constipation so that there was no straining or bearing down motion when using the toilet. This would have brought huge gushes of fluid out and I was very intent on maintaining baby's little remaining liquor. I changed sanitary pads with each visit too and tried to remain cool and fresh constantly with two little showers each morning and evening. No one apart from my partner used our toilet facilities to help keep foreign bacteria at bay. I used vinegar or Grapefruit Seed Extract in each load of washing in the final rinse to lessen the effects of viruses, fungal or bacterial nasties in my underwear.

Of course keeping as still as possible was found to be helpful in the first 4 weeks after PROM and I only climbed the stairs once per day so that I was very inactive and mainly still. After this time I noticed that the leaks were constant no matter what I did while remaining virtually horizontal at all times. I then allowed myself periods of sitting up reading or watching tv or using the computer to alleviate boredom and keep me contactable. All the time maintaining a calm restful demeanor which was best for baby and I.

My Diabetes continued to remain well controlled despite the massively stressful situation and I suffered no pregnancy oedema or swelling, despite being so sedentary. My obs were always normal and so were the baby's. All scans were showing her to be growing along the 50th percentile on the development charts. Her SDI was always good at each and every scan.

I happily went into labour at 38wk and 4 days and after a 3 hour labour had a gorgeous waterbirth at home with the full support of my partner and midwife. I had an uneventful post- natal period. Our little daughter is immeasurably special after her arduous gestation but she proved to be strong, hardy and resilient and is to this day.

Never lose hope that you can nurture your pregnancy despite PROM! Listen as much as you can to your intuition and inner voice about what seems the best course of action for you and your little one. Have faith in yourself and your ability to protect and grow your baby.