By Paul, Newport Wales
PROM at 21 weeks + 3 days. Delivery at 38 weeks + 2 days.
Story added: 2014-11-11

Donna and I were delighted to find that we were expecting just weeks after deciding we wanted to start a family. Until the twenty-week scan there was no sign that anything was amiss; the sonographer could not make out baby’s diaphragm or heart chambers, so we were rebooked for another scan at 22 weeks. In the meantime, Donna was using pads for a bit of wetness, but she thought nothing of it and put it down to sweating. At the re-scan, the sonographer found what she was looking for but towards the end of the scan called in a colleague “to check something”. They found that Donna had an AFI of 3.8cm, which meant nothing to us but, as was explained in the gravest of tones, was not good for the baby at all. We were immediately sent up to the Obstetric Assessment Unit but were not seen for three nightmarish hours, and when Donna was examined the assessment was grim, a midwife identifying pooling of fluid; a doctor was called, however she was a locum with very little experience and who practically introduced herself by asking “So you want to keep the baby?” Traumatised, we were sent home with a pack of Erythromycin and a garbled message about ‘expectant management’. Of course, we looked up PROM on the internet and cried ourselves to sleep. Two endless days later we had an appointment with the Fetal Medicine unit, who explained that the situation was likely to end in labour within seven days, and even if the fluid recovered (it was 4.3 when measured) to a normal level the days when it was low could already have permanently affected baby’s lungs – as the literature said, there was a ‘dismal prognosis’ for the little one. We were also advised that termination might be an option, though we were never explicitly advised to terminate. All our excitement about the pregnancy had turned to anxiety, and though we attended antenatal clinic every week, baby continued to grow normally, and the fluid levels continued to creep up towards normal levels, we never felt remotely assured that everything was going to turn out as we hoped. Donna took time off work and did almost nothing but drink water, though we were advised that it wouldn’t necessarily be helpful. At 29 weeks, Donna had a sickness and diarrhoea bug and was sent up to the maternity ward for observation; we feared that the doctors were going to start procedures to deliver the baby, but luckily she improved and came home the next day. Donna had steroids at 30 weeks and the visits to ante-natal continued; though she still leaked some fluid, the amounts were smaller and scans continued to show normal development. Yet still in the back of our minds was the information about how the baby’s lungs could have been damaged in the vital period when the fluid was low. 30 weeks became 32, 34, 36, and still there was no infection, no sign that baby was not doing well; one doctor advised she would book us in to be induced at 37 weeks – she was overruled by her consultant and we were eventually called in the day before 38 weeks. Induction was slow in taking effect; the midwife had to break Donna’s waters – of which there was a lot! – and said that she had probably suffered a ‘hindwater’ tear, meaning that when Donna ruptured it was in a place where it would only leak out at a certain level, and/or baby might have blocked it from coming out at times. Anyway, after a weekend of waiting, and a surprisingly short amount of pushing, Sophia Lily was born at 38 weeks and 2 days. After a shot of oxygen, she cried and breathed, a perfectly healthy, petite (6lb 5oz) daughter. We stayed in hospital for 2 days just so Sophia could get antibiotics for possible sepsis, but we brought her home a mere 60 hours after she was born. Our journey has the happiest of endings, but we still think of that terrible night when the rupture was diagnosed and we were asked if we wanted to keep our baby. I realise we have been incredibly lucky and not every incidence of PPROM has such an uncomplicated outcome, but I hope our story gives some reassurance to those coping with the endless doom and gloom that seems to surround a diagnosis of PPROM.