By Colie, Denver,CO USAMy story of infertility, incompetent cervix, pPROM, resealed membranes, and a miraculous FULL-term baby!
PROM at 22 weeks + 5 days. Delivery at 38 weeks + 4 days.
Story added: 2010-08-28
After 8 years of infertility following a loss, in summer 2009 we started to get a serious fertility workup. I had a HSG which showed everything was clear. My tubes were flowing, there was no scar tissue on my ovaries, everything looked fine. I had a cervix biopsy to check for cancerous cells since I go months (9 was the most) with no natural period. It came back clear. We had hubby sperm tested, no issues there as well. So, they gave me drugs to force a period and the plan was to start me on Clomid (to force ovulation).
First cycle: Sept 2009. Clomid 50mg for 5 days. I had two follicles, so I DID ovulate, but a BFN.
Second cycle: Oct 2009. I only got through 3 of my 5 Clomid pills before my PCP took me off the fertility drugs. I had significant health issues found in many scans, we thought it was cancer spreading. I still tested at the end of the cycle, BFN.
Third cycle: Nov 2009. I was told NOT to get pregnant while we checked out all the tumors. Lung specialist gave me the okay. Liver specialist gave me the okay. However, everyone wanted my GB taken out before we tried to get pregnant again. No fertility drugs this month.
Dec 2009: I have my surgery, everything goes well, They remove my GB which was inflamed and had stones, they cut out the largest tumor from my liver (left two tiny ones in there), but all were benign. I was weak but my dr gave me the okay to drive to TX for Christmas. Uneventful, but I just took it easy because I was still recovering from the surgery. I had some spotting two days before the surgery, but I didn't think anything of it because I had been on my PCOS medication for awhile.
Jan 2010: I realized I hadn't taken a PG test in awhile. I wasn't hungry, the smell of some food was making me sick, and I was tired. I honestly though this was all because of the surgery. at 4:30am on Jan 5 I took a test (digital) it said PREGNANT. I was hysterical. I hadn't had any sex since the surgery which means I was pregnant during the surgery. I told hubby but couldn't stop crying. We ended up at the PCP office that day. She confirmed we were pregnant and looked at the surgeon report and tried to convince me that nothing in the surgeons report indicated anything that would have harmed the baby. We went to the fertility clinic three days later and saw the HB on an u/s. There was ONE baby and there was a HB.
Once I saw the HB I told everybody. I was 8 weeks that day. I posted it on FB, sent texts to my family, I just couldn't stop crying. Then it hit me, why in the hell had I told anyone. For the next 4 weeks I walked on eggshells, stopped drinking coffee, ate only organic, cancelled my trip to Puerto Rico, ANYTHING I could think of to keep it mellow. With PCOS the rate of m/c in tri 1 is higher than the typical pregnancy.
We made it to week 13 and my NT scan was perfect. LO had a HB, no markers for downs, trisomy, etc... we had made it!
I still took it easy. I am a SAHW who works part-time online so I was pretty much on "light duty".
19 weeks, our big anatomy scan. Baby looked GREAT. I asked about the placenta and cervix, they told me both were fine. We did not find out the gender, we were team green. I really breathed a sigh of relief. I contemplated switching to a midwife since I wasn't having any complications. They told me then that there was a higher risk of IUGR because of my liver issues and they wanted a growth scan at 31-32 weeks just as a precaution. I was excited to be able to see the baby again.
Fast forward to week 22. I was feeling uncomfortable. Had trouble sleeping, some cramping and pain which I assumed were round lignament pains. Having lots of discharge, but hey, that is "normal" right?
THAT DAY
22w3d (Monday). I took my hubby to the dr that day to get checked for strep and mentioned the pain to my PCP. I thought maybe BH so I decided I would just be sure to ask at my appt on Friday. We got home and something didn't feel right. I immediately went to the nearest ER. Crying hysterically.
Baby looked great on the NST, no contractions with steady HB. They told me that they would send me home in a few hours if nothing changed. I was so embarrassed. I was hysterical for nothing. This was before the internal exam. Turns out I was 3 cm dialated and my water sac distended into my vaginal canal. OB came in with a u/s and told us delivery was likely eminent. She was going to contact my OB/peri to see what they said.
My hospital refused to take me as a transfer. The OB sent me to another hospital where a doctor was willing to examine me and possibly attempt a rescue cerclage. I made it without my water breaking to the new hospital. After a discussion with the dr and an amnio that came back clear he told me they could do it. They pushed the sac back in my cervix and stitched it shut. Plan was wait & see with 7 days in hospital because of the high risk of infection. Then I would go home for home bedrest.
Plan changed when my water broke on Wednesday. The cerclage held and the leak appeared to be slow. Insurance insisted I be transferred to my regular hospital. There everything was relatively quiet. With the exception of a large gush on the 3 or 4th day and some non-reactive NSTs my stay was pretty calm. I was given steroid shots at 23w1&2 days.
Baby always had plenty of fluid (8cm- 13cm on weekly AFIs), but she was measuring small. After my last gush on April 25th I really didn't leak anymore. I was officially declared resealed on May 28th following a fern swab, speculum exam, and u/s fluid check. So hospital bedrest turned into home bedrest. I went to the hospital every Friday for a NST, MFM visit, and fluid check. I also had a home healthcare nurse on Tuesdays to give me a NST and check my vitals.
Fast forward to week 36, as nothing much happened since my release, they removed my cerclage and there was no spontaneous rupture of my water or contractions that immediately started. SO DISAPPOINTED!
I went to L&D twice with false labor but I was at 4-5cm 80% effaced with no additional progress.
Come to August 10th, sorry background is so long. I woke up at 5am with cramps which I quickly realized were pretty regular and quickly turned into full-blown contractions. I REFUSED to time them as I assumed they would fizzle. My home health nurse came for my regularly scheduled NST and she told me they were 3-4 min apart but I didn't feel they were increasing in intensity. This turned out to not matter as Chloe failed her first home NST. One one accel that was 20x20 in the first minute and it took another 50 to get a second one. I called hubby he came home and we headed for L&D after my home health nurse confirmed with the hospital they wanted me to come in.
On the way I felt her move ONCE. I was getting very worried but about halfway through the 45 min drive she kicked three times and I burst out crying. I was really trying not to worry my husband and wondering if we just just have gone to the closest hospital or ours.
We get to L&D where she passes her strip. Honestly she still wasn't getting 20x20s as she normally does and her movement was really decreased but they seemed satisfied. I tell midwife I have been contracting since 5am and she decided to check me before they sent me home. I was then 6cm, 100% effaced and at -2 station. She went off to speak with my high-risk fellow. She came back and said I was being admitted. YAY! However, they had no rooms as a lady on her 7th child just took the last one. I got my antibiotics for GBS and then walked the halls for what seemed like HOURS. I got checked and I was still at a 6, but she was now 0 or even +1 stage. So the walking did make her drop. They hooked me up with pitocin and I started off. Quickly I was at contractions 2-3 min. I got checked 1- 2 hours laters and I was at 8cm. Pitocin was turned up gradually from 1 to 4 by the end. Another hour later (after shift change) I was doubting my ability to do this natural. I wanted to know 1) if I had made anymore progress 2) if they intended to break my water to speed things up and 3) what my pain options were.
I decided against IV drugs as they cross the placenta. I was trying to decide on an epi and when they told me I was still at 8cm, 9 with contractions I decided to have them break my water and see if it led to a speedy remainder. Can you believe they actually had to BREAK my water???
I pushed for an hour and 20 min total. I was having trouble breathing. Chloe's heartrate dropped a few times. I was scared as hell.
I was actually delivered by a 1st year medical student and a 1st resident. In the room was an attending, two nurses, and a 3rd or 4th year resident as well. So my team was 6 people. No NICU/pedis.
Total "labor" 14 hours 20 min. Pushing 1 hour 20 minutes. She came out and they placed her on my chest and I broke down and cried worse than I did this entire pregnancy and just kept crying. It feels so good to have an outside baby. Hubby cut the cord what seemed like 5 min later and then they went to work on me while Chloe laid on my chest skin-to-skin.