By Liz, Raleigh, NC USA
PROM at 16 weeks + 5 days. Delivery at 23 weeks + 3 days.
Story added: 2009-08-20

After 2 years of trying to conceive, we decided to try the IVF route. Our first try was successful, so successful, that were were elated to learn we were expecting twins. For the first 12 weeks of the pregnancy, everything went great. No morning sickness, nausea at all. There were days when I forgot I was pregnant b/c I felt so good. Starting around week 13, I started to notice some odd vaginal discharge but according to the docs, it was nothing to worry about. The discharge continued on and off for the next few weeks and I just didn't feel right. Well, at 16 weeks, 5 days, I stood up to go to the bathroom and experienced a huge gush of fluid. What was confusing was that it was bloody fluid so when I spoke to the OB/GYN on call, she thought, I might have Placenta Previa (Twin A's placenta was very close to the Cervix). Thinking nothing of it, we went in for an Ultrasound the following day and that's when the real nightmare began. I was told that Twin B's fluid was low. In shock and not really understanding it all, I was sent home and put on bed rest and was to be seen the following week for a follow up ultrasound in hopes that that the rupture had healed and fluid levels had increased. The next week went by painfully slow but the day finally came and we went in with high hopes that fluids were replinished. Unfortunately, it had not but the doctor we spoke to seemed to be optimistic for us. She stated that since I had not gone into labor yet, that the chances my pregnancy would continue were good. Additionally, since it was Twin B's sac that had ruptured, we had Twin A acting as a protective barrier. We went home feeling a little better but still cautiously optimistic. The biggest risk we were told was that of infection. I did everything I could, stayed in bed except to use the bathroom, shower or go to the doctor. I drank water like it was my job, 1-2 gallons a day. Each week, fluid levels were maintained for Baby B. At the 21 week growth ultrasound, both babies were growing at slightly above average rates. We really thought we were going to beat this thing and make it to a viable period. Well, unfortunately, at 23 weeks (5 days before I was to go into the hospital), I passed what seemed to be my mucous plug. Still hopeful we'd make it to a viable stage, we marched on but each day I seemed to get worse. At 23 weeks, 2 days, I woke up to the absolute worst stomach cramps ever. Was sent to the triage unit at the hospital and when the doctor did a cervical exam, we heard the three words I would hope no woman will hear..."I see cord". The doctor was shocked b/c this was Baby B's cord and in the 30 years he had practiced medicine, he had never seen a prolapsed cord from a Twin B ruptured sac. He couldn't believe that the cord had found it's way past Twin A through my very closed cervix. At this point, they were still worried that I had an infection but did discuss the option of clamping Baby B's cord to save Baby A. Unfortunately, after calling the pertionologist in, they confirmed that I was infected and that the only option was for me not to be pregnant anymore. They left my husband and I to be alone for a few moments then it was like all hell broke loose. I was put on IV and triple antibiotics and prepped for a labor delivery room. They started Pitocin but realized that my body did not want to go in to labor. I was 0% effaced and was not even 1 cm dilated. With the results of my blood test back (my white blood cell count was at 21, 13 is when things start to go bad), they did not want to wait for the Pitocin to take it's sweet time. So, they placed a pill next to my cervix that was supposed to thin it out. Well, after 5 doses of that darn pill, I finally started to dilate a whole 2 cm. Since the babies were so small, they didn't need me to get to 10 cm but they needed me at at least 5 cm. It was a nightmare. Approximately, around 1 hours before I delivered (still no progress), the doctor decided to break Baby A's sac. It was so heartbreaking b/c I know she had no clue what was going on and she was just in there minding her own business. After the sac was broken, they put me back on Pitocin and within the hour, I was delivering our babies. Baby A, named Stacy, came into the world crying and breathing. She stayed with us for about an hour and was absolutely gorgeous. Unfortunately, due to the prolapsed cord, Baby B, named Walter, was still born. Regardless, we held them for about an hour until they decided I needed to get a D&C b/c I was unable to deliver the placentas and needed to get those out of there b/c of the infection. We still don't know what caused the PPROM and may never know. I think we'll always ask, what could the doctors have done differently? Why did the infection take so long to present itself? Could we have saved Baby A? What I will say is that there is some hope with PPROM as long as you can ward off infection. I read that some doctors will automatically put you on antibiotics, maybe that would have helped us. I guess we'll never know. We're on the road to recovery now, and there are 2 additional stars in the sky.